MEDICARE: BLAKE MEDICAL CARE SC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1013663749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLAKE MEDICAL CARE SC

Provider Business Mailing Address
First Line	:	1350 COUNTRY CT
Second Line	:
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-1029
Country	:	US
Telephone Number	:	847-984-3290
Fax Number	:

Provider Business Practice Location Address
First Line	:	131 E PARK AVE STE 103
Second Line	:
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-2858
Country	:	US
Telephone Number	:	847-984-3290
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KATHERINE BLAKE
Credential	:	DO
Telephone Number	:	847-984-3290

Provider Enumeration Date	:	02/22/2022
Last Update Date	:	02/22/2022

Similar Medicare Providers

1225304322 — DR. KATHERINE M BLAKE D.O.
Practice Location Address:

131 E PARK AVE STE 103
LIBERTYVILLE, IL
60048-2858

Practice Phone: 847-984-3290
Practice Fax: 847-255-2015

1134863749 — NORTHSTAR REHAB PAIN CLINICS PLLC
Practice Location Address:

131 E PARK AVE STE 103
LIBERTYVILLE, IL
60048-2858

Practice Phone: 847-393-6246
Practice Fax:

1043161060 — MODERN PAIN MANAGEMENT SC
Practice Location Address:

1795 N BUTTERFIELD RD STE 108
LIBERTYVILLE, IL
60048-1212

Practice Phone: 773-818-1544
Practice Fax:

1609121219 — DR. MIKIN VIRENDRA PATEL MD
Practice Location Address:

1870 W WINCHESTER RD STE 146
LIBERTYVILLE, IL
60048-5359

Practice Phone: 847-584-3959
Practice Fax:

1477303691 — DR. KATHERINE ADA MURZANSKI DNP, AGPCNP-BC
Practice Location Address:

1870 W WINCHESTER RD STE 146
LIBERTYVILLE, IL
60048-5359

Practice Phone: 847-584-3959
Practice Fax:

1790917557 — OSMANUDDIN SYED AHMED MD
Practice Location Address:

1870 W WINCHESTER RD STE 146
LIBERTYVILLE, IL
60048-5359

Practice Phone: 847-584-3959
Practice Fax:

Directions to “BLAKE MEDICAL CARE SC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.