Individual
MR. CHARLES WARREN BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS,MS,CTRS
Contact information
Practice address
15900 S CICERO AVE, OAK FOREST, IL 60452-4006
(708) 633-3066
Mailing address
1514 ELWOOD ST, WILMINGTON, IL 60481-1026
(815) 476-2348
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
06/28/2007
Last updated
07/08/2007
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