Marcia E. Blake, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-006808 Issued in IL

Legal business name

MARCIA E. BLAKE, O.D.

Practice address

1903 W 103Rd St
Chicago, IL 60643-2624

Phone

(773) 233-7799

Fax

(773) 233-6362

NPI assigned

Mar 27, 2014

Last updated

Mar 27, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Marcia E. Blake, O.D.NPI 1053490219

Title

Owner

Phone

(773) 233-7799

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marcia Ellen Blake, O.D.

  • Optometrist
  • Chicago, IL
  • NPI 1053490219
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395878400000",
    "number": "1205253200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 W 103RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432624",
            "telephone_number": "773-233-7799",
            "fax_number": "773-233-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 W 103RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432624",
            "telephone_number": "773-233-7799",
            "fax_number": "773-233-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCIA E. BLAKE, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-27",
        "last_updated": "2014-03-27",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-233-7799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-006808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilena Dorelle Marchetti, M.S.
• Sarah Marchetti, LAC
• Isabela Dos Santos Marchi, M.ED., M.S.ED.
• Meenakshi Marchione
• Patricia Marchman, LCSW
• Marcia S Nickow LTD
• Marcia Slomowitz MD PC
• Orry Matthew Marciano
• Marcie a. Claybon MD PLLC (Bian Medical)
• Judith Lynn Marcin, MD

• Optometrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.