Individual
THEA BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CGC
Contact information
Practice address
1950 W POLK ST, FL 7 CUB 64, CHICAGO, IL 60612-3726
(312) 864-0333
Mailing address
3647 N KEELER AVE, CHICAGO, IL 60641-3014
(773) 208-5239
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
247.000180
IL
Other
Enumeration date
04/12/2023
Last updated
04/12/2023
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