Organization
BLOOM PLASTIC SURGERY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB BLOOM MD (OWNER)
(847) 826-9239
Entity
Organization
Contact information
Practice address
150 E HURON ST, SUITE 801, CHICAGO, IL 60611-2999
(312) 549-8961
(312) 549-8962
Mailing address
150 E HURON ST, SUITE 801, CHICAGO, IL 60611-2999
(312) 549-8961
(312) 549-8962
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
336.095798
IL
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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