Bloominger, Mary Jo

Bloominger, Mary Jo is an individual health care provider with primary practice located at 2550 24Th St , Rock Island IL 61201-5304. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Bloominger, Mary Jo can be contacted via phone (309) 793-4223.

Contact Information

Primary practice address
2550 24Th St Rock Island IL 61201-5304
Phone: (309) 793-4223
Fax: (309) 793-6276
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X Illinois

Profile Details

NPI number 1174503726
LBN Legal business name Bloominger, Mary Jo
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated Dec 28th, 2007 - about 17 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 1174503726 NPPES
Iowa Other 90720 BLUE SHIELD

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