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General NPI Number Information
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NPI Number | 1174427223
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Entity Type | Organization
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Legal Business Name | INNER BLOOM THERAPY PLLC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 1901 N ROSELLE RD STE 800
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City | SCHAUMBURG
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State | IL
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Zip | 60195-3186
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Country | US
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Telephone | 331-245-9849
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Fax |
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Provider Business Mailing Address
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Address Line | 1579 ARDMORE AVE
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City | GLENDALE HEIGHTS
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State | IL
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Zip | 60139-2505
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Country | US
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Telephone | 331-245-9849
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER SLIPKEVYCH
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Credential | LCSW
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Telephone | 331-245-9849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | NULL
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