GEORGETTE BLOOM


Address: 3010 Grand Ave, Floor 1, Waukegan, IL 60085-2321
Phone: 8473778180

GEORGETTE BLOOM (NPI# 1528088895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1528088895
Entity Type Individual
Full Name GEORGETTE BLOOM
Credential CPC
Practice Address 3010 Grand Ave
Floor 1
Waukegan
IL 60085-2321
Practice Telephone 8473778180
Practice Fax Number 8479845682
Mailing Telephone 8473778180
Mailing Fax Number 8479845682
Enumeration Date 2006-07-20
Last Update Date 2012-08-28
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional
180.001111 IL Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
IL 180001111 05

Office Location

Street Address 3010 GRAND AVE
FLOOR 1
City WAUKEGAN
State IL
Zip Code 60085-2321

Providers in the same location

NPI Name Taxonomy Address Enumeration
1144837758 Danielle Candelario Pharmacist 3010 Grand Ave, Waukegan, IL 60085-2321 2020-09-28
1740895481 Ashley Perez Counselor 3010 Grand Ave, Waukegan, IL 60085-2321 2020-09-10
1528672839 Haley Juliet Rainwater Counselor 3010 Grand Ave, Waukegan, IL 60085-2321 2020-09-03
1477165090 David Quintel Howery Counselor 3010 Grand Ave, Waukegan, IL 60085-2321 2020-08-17
1558994228 Alma Bertha Griffin Registered Nurse 3010 Grand Ave, Waukegan, IL 60085-2321 2020-02-20
1427694413 Shahzadhi Nyakhar Community Health Worker 3010 Grand Ave, Waukegan, IL 60085-2321 2019-11-25
1184269623 Jennifer Marie Winesburg Registered Nurse 3010 Grand Ave, Waukegan, IL 60085-2321 2019-11-07
1225672157 Tina Arnold Counselor 3010 Grand Ave, Waukegan, IL 60085-2321 2019-11-04
1003465592 Sindy Lorena Guerra Counselor 3010 Grand Ave, Waukegan, IL 60085-2321 2019-09-06
1467008474 Alexandra Noelle Weidner Counselor 3010 Grand Ave, Waukegan, IL 60085-2321 2019-08-15
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1285285189 Allison Rose Matuszewski Speech-Language Pathologist Robbie M. Lightfoot, 1721 N Mcaree Rd, Waukegan, IL 60085 2019-09-23
1164985602 Kristin Kaprak Speech-Language Pathologist Thomas Jefferson Middle School, 600 S. Lewis, Waukegan, IL 60085 2019-04-11
1861972317 Mitchum Smith Student in an Organized Health Care Education/Training Program 2025 Washington Street, Waukegan, IL 60085 2018-08-15
1447702998 Rachel Martinez Registered Nurse 3002 Grand Ave., Waukegan, IL 60085 2016-11-01
1831649250 Kenneth Caples Specialist/Technologist 211 S County St, Waukegan, IL 60085 2016-10-10
1033666490 Catholic Charities of The Archdiocese of Chicago Community/Behavioral Health 671 S. Lewis Ave., Waukegan, IL 60085 2016-09-02
1285007757 Michael Moore Counselor 1113 Greenwood Ave, Waukegan, IL 60085 2015-11-05
1740656503 Emperatriz Guerra Counselor 329 N. Genesee Street, Waukegan, IL 60085 2015-08-17
1992189880 County of Lake Clinic/Center 540 S. Mcalister Ave., Waukegan, IL 60085 2015-07-10
1922406354 Ebele Okonkwor Nurse Anesthetist, Certified Registered 1324 N. Sheridan, Waukegan, IL 60085 2014-12-17
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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1982268017 Michael Donavan Wilson Counselor 200 North Lewis, Waukegan, IL 60087 2019-04-24
1174039556 Amanda Catherine Leonard Counselor 20 S County St, Waukegan, IL 60085-5504 2017-12-20
1225388812 Linda A Hochfeld Counselor 320 Grand Ave, Waukegan, IL 60085-4225 2012-09-11
1417250192 Rebecca Vinson-boyer Counselor 2835 Belvidere Rd, Suite 214, Waukegan, IL 60085-6046 2010-12-17
1851557599 David R Stiver Counselor 2233 Yeoman St, Waukegan, IL 60087-4814 2008-08-01
1407480619 Meredith Robbins Counselor 2025 Washington St, Waukegan, IL 60085-5131 2020-02-26
1043875628 Mary Thorson Counselor 2025 Washington St, Waukegan, IL 60085-5131 2019-05-08
1497226930 Gina Young Counselor 671 S Lewis Ave, Waukegan, IL 60085-6101 2018-12-10
1487135042 Jamie Gallo-weinstein Counselor 1113 W Greenwood Ave, Waukegan, IL 60087-4908 2018-08-22
1801375100 Teresa Kaye King Counselor 3010 Grand Ave, Waukegan, IL 60085-2321 2018-08-08
Find all providers in WAUKEGAN

Competitor

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City WAUKEGAN
Zip Code 60085

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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