| Doctor Name: | HEATHER LEE BLAKE |
| NPI Number: | 1720280654 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MPT |
| License Number: | 070.012919 |
| Business Practice Address: | 152 S Bloomingdale Rd Unit 101 Bloomingdale, IL - 601081481 |
| Business Phone Number: | 6308935534 |
| Business Fax Number: | 6308935527 |
| Mailing Address: | 26806 Basswood Cir, PLAINFIELD |
| State: | IL |
| Postal Code: | 605852932 |
| Phone Number: | 6308935534 |
| Fax Number: | 6308935527 |
| NPI Enumeration Date: | 06/04/2007 |
| NPI Last Update Date: | 09/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 070.012919 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |