Organization
BLOOMWELL FAMILY CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEIDRA HALL APN (OWNER)
(312) 399-1725
Entity
Organization
Contact information
Practice address
8702 SEDGE MEADOW DR, WONDER LAKE, IL 60097-7604
(312) 399-1725
Mailing address
8702 SEDGE MEADOW DR, WONDER LAKE, IL 60097-7604
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/19/2025
Last updated
09/19/2025
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