Bloomer, William David

Bloomer, William David is an individual health care provider with primary practice located at 2650 Ridge Ave , Evanston IL 60201-1718. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Bloomer, William David can be contacted via phone (847) 570-2590.

Contact Information

Primary practice address
2650 Ridge Ave Evanston IL 60201-1718
Phone: (847) 570-2590
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X Illinois

Profile Details

NPI number 1033158639
LBN Legal business name Bloomer, William David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1033158639 NPPES
Illinois MEDICAID 03608368028

Popular Providers