Bloom, Matthew

Bloom, Matthew is an individual health care provider with primary practice located at 825 N Main St , Canton IL 61520-1264. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Bloom, Matthew can be contacted via phone (309) 647-2610.

Contact Information

Primary practice address
825 N Main St Canton IL 61520-1264
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 051287329 Illinois

Profile Details

NPI number 1720680804
LBN Legal business name Bloom, Matthew
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 12th, 2020
Last updated Nov 12th, 2020 - about 5 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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