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NPI Code Detail

MEDICARE: DANA BLOEMER

MEDICARE: DANA BLOEMER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerIL

General Provider Information

NPI Number : 1568596971
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA BLOEMER
Provider Business Mailing Address
First Line : 917 N HERMITAGE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60622-5003
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2100 W HARRISON ST
Second Line : SUITE 10
City : CHICAGO
State : IL
Zip : 60612-3706
Country : US
Telephone Number : 312-864-6573
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2007
Last Update Date : 07/08/2007

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Directions to “ DANA BLOEMER ” Practice Location

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