Individual ProviderMarin A BlakeSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address1459 N Bosworth Ave, Apt 3f, Chicago, IL 60622-7013(617) 501-5851PECOS EnrollmentBased on the most recent information from CMS, provider Marin A Blake does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1194856674Provider TypeIndividualFull NameBlake, Marin ATitleMs.CredentialCCC-SLPGenderFemaleSole ProprietorYesEnumeration Date3/8/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address1459 N Bosworth Ave, Apt 3f, Chicago, IL 60622-7013Phone(617) 501-5851FaxUnlisted FaxMailing LocationMailing Address1459 N Bosworth Ave, Apt 3f, Chicago, IL 60622-7013Phone(617) 501-5851FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicenseUnlisted IssuerIllinois