Individual
DR. ZACHARY D. BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3633 WEST LAKE AVE, SUITE 404, GLENVIEW, IL 60026
(847) 204-0943
(407) 522-4671
Mailing address
621 DUNSTEN CIR, NORTHBROOK, IL 60062
(847) 204-0943
(847) 509-8452
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
180.010958
IL
106H00000X
Marriage & Family Therapist
Primary
166001123
IL
Other
Enumeration date
05/23/2011
Last updated
05/02/2017
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