Individual provider Active NPI

Danielle Renae Blake

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1295353308
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209021461 Issued in IL
Practice address
200 S Wacker Dr FL 31
Chicago, IL 60606-5877
Phone
(866) 849-0692
NPI assigned
Jul 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209021461 IL Primary
Family Nurse Practitioner 363LF0000X 2020019717 MO
Family Nurse Practitioner 363LF0000X APRN-NP715425 GA
Family Nurse Practitioner 363LF0000X A179227 IA
Family Nurse Practitioner 363LF0000X NPPA075406 PA

Addresses

Primary practice location

200 S Wacker Dr FL 31
Chicago, IL 60606-5877

Mailing address

200 S Wacker Dr FL 31
Chicago, IL 60606-5877
Phone (866) 849-0692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A179227IAMDFamily Nurse Practitioner
209021461ILMDFamily Nurse Practitioner
2020019717MOMDFamily Nurse Practitioner
NPPA075406PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Heart Care CurrentSince Feb 14, 2021 Accepting new patients

Locations

5020 N Illinois St
Fairview Hts, IL 62208
Phone (618) 222-8900

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12464/brand/1/csg/1/fhir/r4

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1295353308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S WACKER DR FL 31",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606065877",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S WACKER DR FL 31",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606065877",
            "telephone_number": "866-849-0692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "DANIELLE",
        "middle_name": "RENAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209021461",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020019717",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP715425",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A179227",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "NPPA075406",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; 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.