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General NPI Number Information
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NPI Number | 1710804737
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Entity Type | Individual
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Provider Name | RANELL ANN BLUE
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Gender | Female
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Dates
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Enumeration Date | 07/01/2026
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Last Update Date | 07/01/2026
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Provider Practice Location Address
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Address Line | 4318 W CRYSTAL LAKE RD STE B
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City | MCHENRY
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State | IL
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Zip | 60050-4299
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Country | US
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Telephone | 815-276-9422
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Fax |
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Provider Business Mailing Address
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Address Line | 3902 SCHUETTE DR
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City | WONDER LAKE
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State | IL
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Zip | 60097-8146
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Country | US
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Telephone | 815-276-9422
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 227.023937
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License Number State | IL
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