Dr Katherine M Blake, DO - Medicare Family Practice in Libertyville, IL

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Dr Katherine M Blake, DO is a medicare enrolled "Family Medicine" physician in Libertyville, Illinois. She went to Lake Erie College Of Osteopathic Medicine, Erie and graduated in 2012 and has 12 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Northwestern Medical Faculty Foundation and her current practice location is 131 E Park Ave Ste 103, Libertyville, Illinois. You can reach out to her office (for appointments etc.) via phone at (847) 984-3290.

Dr Katherine M Blake is licensed to practice in Illinois (license number 036136377) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1225304322.

Contact Information

Dr Katherine M Blake, DO
131 E Park Ave Ste 103,
Libertyville, IL 60048-2858
(847) 984-3290
(847) 255-2015

Map and Direction




Physician's Profile

Full NameDr Katherine M Blake
GenderFemale
SpecialityFamily Practice
Experience12 Years
Location131 E Park Ave Ste 103, Libertyville, Illinois
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Katherine M Blake attended and graduated from Lake Erie College Of Osteopathic Medicine, Erie in 2012
  NPI Data:
  • NPI Number: 1225304322
  • Provider Enumeration Date: 03/22/2012
  • Last Update Date: 05/03/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 0042524480
  • Enrollment ID: I20180322002510

Medical Identifiers

Medical identifiers for Dr Katherine M Blake such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1225304322NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 125-061735 (Illinois)Secondary
207Q00000XFamily Medicine 64086 (Wisconsin)Secondary
207QB0002XFamily Medicine - Obesity Medicine 036136377 (Illinois)Secondary
207Q00000XFamily Medicine 036136377 (Illinois)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Northwestern Memorial HospitalChicago, ILHospital
Northwestern Lake Forest HospitalLake forest, ILHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Northwestern Medical Faculty Foundation45875768143255

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Katherine M Blake allows following entities to bill medicare on her behalf.
Entity NameNorthwestern Medical Faculty Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1346235314
PECOS PAC ID: 4587576814
Enrollment ID: O20031105000541
Entity NameRosalind Franklin University Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1982894911
PECOS PAC ID: 6002902798
Enrollment ID: O20071010000687
Entity NameGanesha Institute Of Neurology And Psychiatry Sc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1629478599
PECOS PAC ID: 0042432296
Enrollment ID: O20141104000962
Entity NameBlake Medical Care Sc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013663749
PECOS PAC ID: 4486032331
Enrollment ID: O20220604000332

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Katherine M Blake is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Katherine M Blake, DO
131 E Park Ave Ste 103,
Libertyville, IL 60048-2858

Ph: (847) 984-3290		Dr Katherine M Blake, DO
131 E Park Ave Ste 103,
Libertyville, IL 60048-2858

Ph: (847) 984-3290

Reviews and Comments


Family Medicine Doctors in Libertyville, IL

Dr. Lisa Anne Newman, MD
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Phone: 847-680-3666    Fax: 847-680-3994
Tae Ho Choi, MD
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Anna Elizabeth Craioveanu, D.O.
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Dr. George Bernard Elvove, M.D.
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Amanda Jane Wojciechowski, M.D.
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Practice Location: 825 S Milwaukee Ave, Libertyville, IL 60048
Phone: 475-732-8008    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.