MEDICARE: SERVICE IN BLOOM, INC.

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
1	253Z00000X	In Home Supportive Care Agency	3001117	IL

General Provider Information

NPI Number	:	1609221811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERVICE IN BLOOM, INC.

Provider Business Mailing Address
First Line	:	200 E RANDOLPH ST
Second Line	:	5100-10
City	:	CHICAGO
State	:	IL
Zip	:	60601-6436
Country	:	US
Telephone Number	:	312-391-5480
Fax Number	:	312-233-0063

Provider Business Practice Location Address
First Line	:	200 E RANDOLPH ST
Second Line	:	5100-10
City	:	CHICAGO
State	:	IL
Zip	:	60601-6436
Country	:	US
Telephone Number	:	312-391-5480
Fax Number	:	312-233-0063

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAMITA MCCOY
Credential	:
Telephone Number	:	312-391-5480

Provider Enumeration Date	:	04/26/2016
Last Update Date	:	04/26/2016

Similar Medicare Providers

1942416193 — DORIS PEACE KRASNOPOLSKY LCPC
Practice Location Address:

200 E RANDOLPH ST , SUITE 5100
CHICAGO, IL
60601-6436

Practice Phone: 312-577-7630
Practice Fax: 312-233-0063

1356581169 — DR. ROSLIND AILENE BOWENS PHARM.D.
Practice Location Address:

200 E RANDOLPH ST , SUITE 5300
CHICAGO, IL
60601-6436

Practice Phone: 312-453-7011
Practice Fax:

1407126709 — AFTAB AHMAD BME
Practice Location Address:

200 E RANDOLPH ST , SUITE 2200
CHICAGO, IL
60601-6436

Practice Phone: 312-334-2504
Practice Fax:

1972858058 — DORI PEACE, LLC
Practice Location Address:

200 E RANDOLPH ST , SUITE 5100
CHICAGO, IL
60601-6436

Practice Phone: 312-577-7630
Practice Fax: 312-233-0063

1750608956 — MR. CHEZ FRANCIS CRISTIANO PSY.D.
Practice Location Address:

200 E. RANDOLPH STREET , STE 5100
CHICAGO, IL
60601

Practice Phone: 646-650-5262
Practice Fax:

1437929882 — DANIEL KARL NENNIG
Practice Location Address:

333 N MICHIGAN AVE STE 2400
CHICAGO, IL
60601-4040

Practice Phone: 773-609-0361
Practice Fax:

Directions to “SERVICE IN BLOOM, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.