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Individual

DR. BLAKE ALLEN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
225 W WASHINGTON ST STE 1500, CHICAGO, IL 60606-3485
(847) 504-5000
(847) 504-5015
Mailing address
225 W WASHINGTON ST STE 1500, CHICAGO, IL 60606-3485
(847) 504-5000
(847) 504-5015

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004391
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
016004391
IL LICENSE
IL
05
016004391
IL
01
07000838
IN LICENSE
IN
05
200136480E
IN
01
480017243
RAILROAD MEDICARE
IL
01
859800F
ADMINISTAR FEDERAL PIN
IN
01
P01675626
RAILROAD MEDICARE
IN
Enumeration date
07/06/2006
Last updated
10/21/2025
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