Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Katherine M Blake, DO

Individual provider Family Medicine Physician · NPI 1225304322

Dr. Katherine M Blake, DO is a Family Practice in Libertyville, Illinois. Graduated from Lake Erie College of Osteopathic Medicine, Erie in 2012, 14 years ago. Practices with Lakeshore Medical Clinic LLC, a 379-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Illinois and Wisconsin.

Years since qualifying
14
Trained at
Lake Erie College of Osteopathic Medicine, Erie
Licensed in
IL, WI
In the registry since
2012
Specialties on file
4
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

131 E Park Ave Ste 103
Libertyville, IL 60048-2858
Phone: (847) 984-3290
Fax: (847) 255-2015
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 635 N Dearborn St Ste 100, Chicago, IL 60654-4618 — (312) 694-2127
  • 6609 W Greenfield Ave, West Allis, WI 53214-4958 — (414) 257-8577

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 036136377 (IL)
Family Medicine Physician Taxonomy 207Q00000X · Licence 125-061735 (IL)
Obesity Medicine (Family Medicine) Physician Taxonomy 207QB0002X · Licence 036136377 (IL)
Family Medicine Physician Taxonomy 207Q00000X · Licence 64086 (WI)

Record details

NPI number1225304322
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 22, 2012
Last updated in NPPESMarch 10, 2026
Certification dateMarch 10, 2026
Mailing address131 E Park Ave Ste 103, Libertyville, IL 60048-2858

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolLAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduated 2012 (14 years in practice)
Group practice Lakeshore Medical Clinic Llc — 379 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Libertyville