Individual
BLAKE MCNAMARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1900 SILVER CROSS BLVD, NEW LENOX, IL 60451-9509
(815) 300-1100
Mailing address
14714 ASTER LN, HOMER GLEN, IL 60491-6968
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209029231
IL
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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