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General NPI Number Information
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NPI Number | 1487855979
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Entity Type | Individual
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Provider Name | DEBBIE LYNN BLOOM RPH
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Gender | Female
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1600 DEERFIELD RD
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-3708
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Country | US
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Telephone | 847-579-0884
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Fax | 847-579-0895
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Provider Business Mailing Address
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Address Line | 3140 CENTENNIAL CT
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-1016
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Country | US
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Telephone | 847-433-1507
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Fax | 847-433-6776
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State | IL
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