Bloom, Kathy Marie

Bloom, Kathy Marie is an individual health care provider with primary practice located at 11411 W 183Rd St , Orland Park IL 60467-9450. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, which is considered as her primary health care specialty. Bloom, Kathy Marie can be contacted via phone (708) 478-1820.

Contact Information

Primary practice address
11411 W 183Rd St Orland Park IL 60467-9450
Phone: (708) 478-1820
Fax: (708) 478-3316
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X

Profile Details

NPI number 1467573717
LBN Legal business name Bloom, Kathy Marie
Credentials DT
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2007
Last updated Apr 10th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467573717 NPPES
Illinois Other 09932114 BLUE CROSS BLUE SHIELD

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