| Jason Josef Blake, LCSW | |
|
7124 Windsor Lake Pkwy, Suite # 10, Loves Park, IL 61111-3800 | |
| (815) 988-3142 | |
| Not Available |
| Full Name | Jason Josef Blake |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 7124 Windsor Lake Pkwy, Loves Park, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780730101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (Illinois) | Primary |
| Entity Name | Georgina Srinivas Rao, M.d., S.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831344480 PECOS PAC ID: 1052477981 Enrollment ID: O20090302000445 |
| Entity Name | In Home Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1497087175 PECOS PAC ID: 3779612395 Enrollment ID: O20100520000116 |
| Mailing Address | Practice Location Address |
|---|---|
| Jason Josef Blake, LCSW 7124 Windsor Lake Pkwy, Suite # 10, Loves Park, IL 61111-3800 Ph: (815) 988-3142 | Jason Josef Blake, LCSW 7124 Windsor Lake Pkwy, Suite # 10, Loves Park, IL 61111-3800 Ph: (815) 988-3142 |
Christina Samulevich, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5681 Whispering Way, Loves Park, IL 61111 Phone: 847-494-3528 | |
Margot Elisabeth Castillo, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 437 Theodore St, Loves Park, IL 61111 Phone: 815-985-9695 | |
Kirsten Ahlberg, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 9951 Rock Cut Xing, Loves Park, IL 61111 Phone: 815-639-8500 | |
Victoria M. Hominick, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 7124 Windsor Lake Pkwy, Suite 17, Loves Park, IL 61111 Phone: 815-282-1807 Fax: 815-282-1003 | |
Tara White, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6268 E Riverside Blvd, Loves Park, IL 61111 Phone: 815-397-2224 | |
Christina Morris, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6268 E Riverside Blvd, Loves Park, IL 61111 Phone: 815-397-2224 Fax: 815-397-2225 | |
Kathleen Brewer, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2108 Coronet Rd, Loves Park, IL 61111 Phone: 815-216-5974 |