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Individual

BLAKE PAXTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
840 W IRVING PARK RD STE 302, CHICAGO, IL 60613-3011
(773) 659-9207
Mailing address
5553 N MAGNOLIA AVE APT 2E, CHICAGO, IL 60640-1332
(773) 360-4548

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
180017013
IL
101Y00000X
Counselor
Primary

Other

Enumeration date
08/19/2020
Last updated
05/13/2025
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