Service in Bloom, Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

3001117 Issued in IL

Legal business name

SERVICE IN BLOOM, INC.

Practice address

200 E Randolph St
5100-10
Chicago, IL 60601-6436

Phone

(312) 391-5480

Fax

(312) 233-0063

NPI assigned

Apr 26, 2016

Last updated

Apr 26, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Damita McCoy

Title

President

Phone

(312) 391-5480

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461628800000",
    "number": "1609221811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E RANDOLPH ST",
            "address_2": "5100-10",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606016436",
            "telephone_number": "312-391-5480",
            "fax_number": "312-233-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E RANDOLPH ST",
            "address_2": "5100-10",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606016436",
            "telephone_number": "312-391-5480",
            "fax_number": "312-233-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERVICE IN BLOOM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-04-26",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "DAMITA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-391-5480"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "IL",
            "license": "3001117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marisa Serrato, M.D.
• Maria Serratto-Benvenuto, MD
• Olivia Serritella
• Elizabeth Ann Sersch, PHARM D
• Joan M Servatius, LCSW
• Services With a Purpose II LLC
• Seryne Collective LLC
• Alhaji Saidu Sesay, NP-C
• Donthamsetti Seshagirirao, MD
• Seshan Subramanian, M.D.,S.C.

• In Home Supportive Care Agency in Chicago, IL
• Providers in Chicago, IL by specialty
• In Home Supportive Care Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; 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.