Bloomfield, Jeremy W

Bloomfield, Jeremy W is an sole proprietor health care provider with primary practice located at 1609 Sherman Ave Suite 302, Evanston IL 60201-3753. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Group Psychotherapy. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Bloomfield, Jeremy W can be contacted via phone (312) 409-5614.

Contact Information

Primary practice address
1609 Sherman Ave Suite 302 Evanston IL 60201-3753
Phone: (312) 409-5614
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 071-006685 Illinois
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071-006685 Illinois
Behavioral Health & Social Service Providers / Group Psychotherapy 103TP2701X 071-006685 Illinois

Profile Details

NPI number 1871517672
LBN Legal business name Bloomfield, Jeremy W
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 26th, 2006
Last updated Feb 23rd, 2009 - about 15 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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