Provider Demographics
NPI:1801951942
Name:BLAKE, SARA B (MD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:B
Last Name:BLAKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:DEPT CH14389
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60055-4389
Mailing Address - Country:US
Mailing Address - Phone:785-295-5307
Mailing Address - Fax:785-270-7646
Practice Address - Street 1:634 SW MULVANE STREET
Practice Address - Street 2:SUITE 209
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-0000
Practice Address - Country:US
Practice Address - Phone:785-295-5330
Practice Address - Fax:785-295-5355
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS6381207V00000X
KS04-33845207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology