MRS. TRACY R BLAKE (RD) – Registered Dietitian, NPI 1851570436
Registered Dietitian
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
311 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in IL
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Provider Addresses for MRS. TRACY R BLAKE (RD)
South 80th Avenue, Palos Park, Palos Township, Cook County, Illinois, 60464, United States
PALOS HEIGHTS, IL 604631256
Phone: (708) 923-5173
Fax: (708) 923-5018
Type: Mailing
Palos Health Surgery Center, 15300, West Avenue, Orland Park, Orland Township, Cook County, Illinois, 60467, United States
ORLAND PARK, IL 604624600
Phone: (708) 403-8400
Fax: (708) 403-8492
Type: Location
15300 WEST AVE STE 221
ORLAND PARK, IL 604624508
Phone: (708) 590-5300
Fax: (708) 590-5310
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-03-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110322000696 | I | Registered Dietitian Or Nutrition Professional | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | 54 | 27 | $0 |
| 97802 | Therapy procedure for nutrition management, each 15 minutes | 36 | 12 | $0 |
Insurance plans in this area (ZIP 60463)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | IL | |
| Vascular Surgery | IL | |
| - | IL | |
| Nurse Practitioner | IL | |
| - | IL | |
| C H I R O P R A C T I C | IL | |
| Family Practice | IL | |
| Physical Medicine And Rehabilitation | CO | |
| - | IL | |
| Hospitalist, Family Practice | IL |
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