Individual
DR. JOHN DOUGLAS BLOOM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3001 6TH ST, GREAT LAKES, IL 60088-2833
(847) 688-2100
Mailing address
3001 6TH ST, GREAT LAKES, IL 60088-2833
(847) 688-2100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
01/09/2006
Last updated
07/08/2007
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