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Individual

ALLEN DAVID BLOOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2040 OGDEN AVE, SUITE 115, AURORA, IL 60504-7206
(630) 585-0200
(630) 585-7396
Mailing address
2040 OGDEN AVE STE 115, AURORA, IL 60504-7205
(630) 585-0200
(630) 585-7396

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036067856
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036067856
IL
Enumeration date
08/25/2006
Last updated
04/08/2020
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