Blake, Tracy R

Blake, Tracy R is an individual health care provider with primary practice located at 15300 West Ave Ste 221 , Orland Park IL 60462-4508. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Blake, Tracy R can be contacted via phone (708) 590-5300.

Contact Information

Primary practice address
15300 West Ave Ste 221 Orland Park IL 60462-4508
Phone: (708) 590-5300
Fax: (708) 590-5310
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 164.004441 Illinois

Profile Details

NPI number 1851570436
LBN Legal business name Blake, Tracy R
Credentials Registered Dietitian (RD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 30th, 2007
Last updated Dec 1st, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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