Robert W Bloom, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036-069110 Issued in IL

Practice address

3633 W Lake Ave
Suite LL19
Glenview, IL 60026-5812

Phone

(847) 657-6007

Fax

(847) 657-6412

NPI assigned

Nov 30, 2005

Sex

Male

Sole proprietor

Yes

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Rush Medical College of Rush University, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Neuropsychiatric Evaluation and Treatment Center

  • Psychiatry Physician
  • Glenview, IL
  • NPI 1619951860
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1609850932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE STE LL 19",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265812",
            "telephone_number": "847-657-6007",
            "fax_number": "847-657-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE",
            "address_2": "SUITE LL19",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265812",
            "telephone_number": "847-657-6007",
            "fax_number": "847-657-6412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-069110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Blanchfield, LCPC
• Shelly Ann Blanski, OTRL
• Alicia Blasi, MOTR/L
• Baylee Kay Bleikamp, OTR/L
• Eric N. Bloom, D.D.S.
• Ronald A Bloom, MD
• Zachary D. Bloom, PH.D.
• Blue Sage Wellness, Inc
• Andrea Lynn Blume, COTA L
• Dawn Blundell, PTA/L

• Psychiatry Physician in Glenview, IL
• Providers in Glenview, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.