Individual
ANITA AMANDA BLOOMINGBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
829 E 153RD ST, PHOENIX, IL 60426-2554
(815) 764-6631
Mailing address
5039 W 18TH ST APT 17, CICERO, IL 60804-1962
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
IL
Other
Enumeration date
06/24/2019
Last updated
07/21/2022
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