Mr. Kenneth J Blake
Mr. Kenneth J Blake is a Driver in Oak Park, Illinois. Registered with an NPI since 2017.
- In the registry since
- 2017
Practice location Address checks out
7115 N Ave # 317Oak Park, IL 60302-1002
Phone: (312) 880-7107
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Driver (primary) | Taxonomy 172A00000X · Licence B42051067019 |
|---|
Record details
| NPI number | 1851818389 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | August 25, 2017 |
| Last updated in NPPES | August 25, 2017 |
| Mailing address | 7115 North Ave # 317, Oak Park, IL 60302-1002 |
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