DR. JACOB MAXWELL-PHILLIP BLOOM (NPI# 1770757130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770757130 |
| Entity Type | Individual |
| Full Name | DR. JACOB MAXWELL-PHILLIP BLOOM |
| Credential | M.D., M.S. |
| Practice Address |
1 E Delaware Pl Ste 501 Chicago IL 60611 |
| Mailing Address |
1 E Delaware Pl Ste 501 Chicago IL 60611-1666 |
| Practice Telephone | 3125353721 |
| Mailing Telephone | 3125353721 |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2019-04-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
036134552 | IL | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | MA254962 | MA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 150 E Huron St Ste 801, Chicago, IL 60611 | 8478269239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730712308 | Jacob Bloom | Counselor | 4076 Kothlow Ave, Menomonie, WI 54751-3090 | 2020-02-21 |
| 1760942494 | Jacob Cameron Bloom | Student in an Organized Health Care Education/Training Program | 830 Harrison Ave Fl 1, Boston, MA 02118-2905 | 2019-03-20 |
| Street Address |
1 E DELAWARE PL STE 501 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255818829 | Kelcy Bai | Physician Assistant | 1 E Delaware Pl Ste 501, Chicago, IL 60611-1666 | 2018-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| 1134735962 | Kalvin Cheuk Hang Lung | Student in an Organized Health Care Education/Training Program | 675 N St Clair St 17th Floor, Chicago, IL 60611 | 2020-09-17 |
| 1487267845 | Ashley Marie Sablich | Student in an Organized Health Care Education/Training Program | 250 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2020-08-26 |
| 1245854033 | Danielle Humphrey | Student in an Organized Health Care Education/Training Program | Pa Program, Suite 1-200, 240 East Huron Street, Chicago, IL 60611 | 2020-06-08 |
| 1801418074 | Sana Healing Collective | Clinic/Center | 405 N. Wabash Street, Chicago, IL 60611 | 2020-05-11 |
| 1194359489 | Insight:eating Disorders, Weight Management & Psychological Centers | Psychiatric Hospital | 1 E. Erie Street, 4th Floor, Chicago, IL 60611 | 2020-02-26 |
| 1902439193 | Iwona Boska | Nurse Practitioner | 676 N St.clair Street, Suite 2140, Chicago, IL 60611 | 2020-02-17 |
| 1922643576 | Sarah Elizabeth Schwartzer | Audiologist | Chicago Dizziness and Hearing, 645 North Michigan Avenue, Suite 410, Chicago, IL 60611 | 2019-11-07 |
| 1023668852 | Anne Marguerite Davidson | Student in an Organized Health Care Education/Training Program | Mcgraw Medical Center, 240 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2019-09-13 |
| 1871141085 | Coast Management | Durable Medical Equipment & Medical Supplies | 40 E. Chicago Ave, Suite 149, Chicago, IL 60611 | 2019-08-30 |
| Find all providers in zip 60611 | ||||
| Taxonomy Code | 2082S0105X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| Specialization | Surgery of the Hand |
| A plastic surgeon with additional training in the investigation, preservation, and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326305632 | Jack Michael Monasterio | Plastic Surgery | 26w295 Glen Eagles Dr, Winfield, IL 60190-2313 | 2012-04-12 |
| 1528368016 | Plastic and Reconstructive Surgery Center Sc | Plastic Surgery | 3443 N Kennicott Ave, Arlington Hts, IL 60004-1431 | 2010-10-30 |
| 1619118536 | Mac Medical Services Corp | Plastic Surgery | 2314 S Route 59, #180, Plainfield, IL 60586-7756 | 2009-03-23 |
| 1508034596 | Theodore D. Fifer | Plastic Surgery | 14900 N Court 9, Effingham, IL 62401-7640 | 2008-02-13 |
| 1487662557 | Vic T. Tsai, M.d., S.c. | Plastic Surgery | 823 129th Infantry Dr Ste 103, Joliet, IL 60435-8347 | 2006-08-04 |
| 1700823879 | Robert C Russell | Plastic Surgery | 320 E Carpenter St, Springfield, IL 62702-5185 | 2006-05-31 |
| 1669475794 | Raymond V Janevicius | Plastic Surgery | 360 W Butterfield Rd, Ste 230, Elmhurst, IL 60126-5000 | 2005-05-23 |
| 1831508910 | Allyne Topaz | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2014-08-04 |
| 1700140613 | Midamerica Orthopaedics, S.c. | Plastic Surgery | 19065 Hickory Creek Dr, Suite 210, Mokena, IL 60448-8507 | 2012-06-26 |
| 1881906535 | Alan Chen Surgical Associates, PC | Plastic Surgery | 823 N 129th Infantry Dr, Ste 103, Joliet, IL 60435-8346 | 2010-07-10 |
| Find all providers with the same taxonomy | ||||
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| 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.