Bloom Plastic Surgery SC

Primary specialty

SpecialistTaxonomy code 174400000X

License

336.095798 Issued in IL

Legal business name

BLOOM PLASTIC SURGERY SC

Practice address

150 E Huron St
Suite 801
Chicago, IL 60611-2999

Phone

(312) 549-8961

Fax

(312) 549-8962

NPI assigned

Aug 9, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jacob Bloom, MDNPI 1770757130

Title

Owner

Phone

(847) 826-9239

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacob Maxwell-Phillip Bloom, MD

  • Plastic and Reconstructive Surgery Physician
  • Chicago, IL
  • NPI 1770757130
  Medicare reassignment Care Compare group NPD Authorized official
• Megan Hosking, PA-C

  • Physician Assistant
  • Chicago, IL
  • NPI 1902373301
  Medicare reassignment Care Compare group
• Himja Bhatt

  • Family Nurse Practitioner
  • Joliet, IL
  • NPI 1285282210

  Single Specialty

  NPD (past)
• Gisela J Yingst, MD

  • Dermatology Physician
  • Palos Heights, IL
  • NPI 1972618619
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1457805244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E HURON ST",
            "address_2": "SUITE 801",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112999",
            "telephone_number": "312-549-8961",
            "fax_number": "312-549-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E HURON ST",
            "address_2": "SUITE 801",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112999",
            "telephone_number": "312-549-8961",
            "fax_number": "312-549-8962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM PLASTIC SURGERY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-826-9239",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "336.095798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoe Blomquist
• Dorothy Katherine Bloniarz, M.D.
• Bloom Behavior PLLC
• Bloom Dental Practice PLLC (South Loop Dental Group)
• Bloom Family Services
• Bloom RX Inc
• Bloom Therapy LLC
• Bloom Wellness LLC (Mind Body Family)
• Bari Bloom
• Carolyn Bloom

• Specialist in Chicago, IL
• Providers in Chicago, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.