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1750588208
CHARLES WARREN BLOOM
OAK FOREST, IL
NPI
1750588208
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225800000X Recreation Therapist
Enumeration Date
2007-06-28
Last Update Date
2007-07-08
Business Address
Mr. CHARLES WARREN BLOOM BS,MS,CTRS
15900 S CICERO AVE
OAK FOREST, IL 60452-4006
Phone number: 708-633-3066
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Mailing Address
Mr. CHARLES WARREN BLOOM BS,MS,CTRS
1514 ELWOOD ST
WILMINGTON, IL 60481-1026
Phone number: 815-476-2348
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