Lisa Robyn Bloom

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146012362 Issued in IL

Practice address

2649 E 75TH St
Chicago, IL 60649-3835

Phone

(773) 356-9300

NPI assigned

Sep 24, 2014

Last updated

Sep 24, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1568864395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2649 E 75TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493835",
            "telephone_number": "773-356-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2649 E 75TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493835",
            "telephone_number": "773-356-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "LISA",
        "middle_name": "ROBYN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146012362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corinne Bloom
• Jacob Maxwell-Phillip Bloom, MD
• Jamie Lawrence Bloom, MD
• Karin Beth Bloom, MSW,LCSW
• Leah Bloom
• Spencer Robert Bloom, DDS
• Susan L Bloom
• Thea Bloom, CGC
• Karen Waisman Bloomberg, PH.D.
• Sherra C Bloomenkranz, OT

• Speech-Language Pathologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.