Individual
BLAKE RECUPIDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
21403 S JEAN AVE, MATTESON, IL 60443-2425
(630) 430-4684
Mailing address
21403 S JEAN AVE, MATTESON, IL 60443-2425
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/02/2026
Last updated
02/02/2026
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