MR. CHARLES WARREN BLOOM (NPI# 1750588208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750588208 |
| Entity Type | Individual |
| Full Name | MR. CHARLES WARREN BLOOM |
| Credential | BS,MS,CTRS |
| Practice Address |
15900 S Cicero Ave Oak Forest IL 60452-4006 |
| Mailing Address |
1514 Elwood St Wilmington IL 60481-1026 |
| Practice Telephone | 7086333066 |
| Mailing Telephone | 8154762348 |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225800000X | Recreation Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174731954 | Charles Henry Bloom | Dentist | 815 Livingston Ave, New Brunswick, NJ 08901-3344 | 2007-05-18 |
| 1285773457 | Charles Stephen Bloom | Obstetrics & Gynecology | 1371 Harmon Ave, Winter Park, FL 32789-5512 | 2007-02-05 |
| 1548202526 | Charles Bloom | Emergency Medicine | 1800 W Charleston Blvd, University Medical Center, Las Vegas, NV 89102-2329 | 2006-06-12 |
| Street Address |
15900 S CICERO AVE |
| City | OAK FOREST |
| State | IL |
| Zip Code | 60452-4006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215955802 | Cook County | Pharmacy | 15900 S Cicero Ave, Oak Forest, IL 60452 | 2006-07-18 |
| 1285254714 | Bill Arong Oben | Pharmacist | 15900 S Cicero Ave, Oak Forest, IL 60452 | 2020-04-24 |
| 1801346689 | Shelby Taylor Jr. | Pharmacist | 15900 S Cicero Ave, Oak Forest, IL 60452 | 2016-10-05 |
| 1902354491 | Ma Lea Kerkstra | Pharmacist | 15900 S Cicero Ave, Oak Forest, IL 60452 | 2016-09-14 |
| 1275081747 | Noel Magsino | Pharmacist | 15900 S Cicero Ave, Oak Forest, IL 60452 | 2016-09-14 |
| 1295024032 | Khadija Ashraf | Pharmacist | 15900 S Cicero Ave, Oak Forest, IL 60452 | 2011-04-01 |
| 1881714111 | Hansa M Kothari | Obstetrics & Gynecology | 15900 S Cicero Ave, Oak Forest, IL 60452 | 2007-03-30 |
| 1972621837 | Sophia Y Chin | Internal Medicine | 15900 S Cicero Ave, Oak Forest, IL 60452 | 2007-03-27 |
| 1275665945 | Naheed H Khan | Internal Medicine | 15900 S Cicero Ave, Oak Forest, IL 60452 | 2007-03-09 |
| 1225167802 | Nivedita J Dave | Radiology | 15900 S Cicero Ave, Oak Forest, IL 60452 | 2007-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831713098 | Oak Family Dental | Dentist | 6056 W. 159th Ave., Oak Forest, IL 60452 | 2020-06-03 |
| 1457982340 | Cook County | Family Medicine | 15900 S. Cicero, Oak Forest, IL 60452 | 2020-01-29 |
| 1265942718 | Suzanne Ankarlo | Speech-Language Pathologist | 3545 West Victoria Drive, Oak Forest, IL 60452 | 2017-10-10 |
| 1154855112 | True Laboratories LLC | Clinical Medical Laboratory | 5320 159th St Ste 505, Oak Forest, IL 60452 | 2017-04-17 |
| 1902347297 | Mena Loka Sr. | Physical Therapy Assistant | 6404 Nature Dr, Oak Forest, IL 60452 | 2017-03-20 |
| 1447797097 | Angelique Mayes-lamon | Clinic/Center | 15900 S Cicero Avenue, Building E, Oak Forest, IL 60452 | 2017-01-20 |
| 1265980759 | Surinder Sharma I | Pharmacist | 15900 So Cicero Ave, 15900 So Cicero Ave Bldg F, Oak Forest, IL 60452 | 2016-09-14 |
| 1326596800 | Gervaise Hunter-morris | Pharmacist | 15900 S. Cicero Avenue, Oak Forest, IL 60452 | 2016-09-14 |
| 1538519111 | Aunt Martha's Youth Service Center, Inc. | Clinic/Center | 15350 Oak Park Ave., Oak Forest, IL 60452 | 2016-06-15 |
| 1760836720 | Thh Acquisition LLC I | Durable Medical Equipment & Medical Supplies | 4149 166th St, Oak Forest, IL 60452 | 2016-04-15 |
| Find all providers in zip 60452 | ||||
| Taxonomy Code | 225800000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Recreation Therapist |
| A recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. |
| Notes: Source: Joel A. DeLisa and Bruce M. Gans, Rehabilitation Medicine: Principles and Practice Second Edition, J.B. Lippincott Company, Philadelphia: 1993, p. 7 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528278728 | Jean Adele Arola | Recreation Therapist | 15712 Revere Ct Apt E, Oak Forest, IL 60452-6030 | 2007-05-23 |
| 1679788954 | Lynda Theresse Orowick-harper | Recreation Therapist | 15900 S. Cicero Ave, Oak Forest, IL 60452-4006 | 2007-05-11 |
| 1508984238 | Dorothea S. Diguido | Recreation Therapist | 15900 S. Cicero Ave, Oak Forest, IL 60452-4111 | 2007-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437631744 | Nicole C Allen | Recreation Therapist | 611 N Almond St, Carbondale, IL 62901-1307 | 2018-09-04 |
| 1700388162 | Ricky L Hoskins I | Recreation Therapist | 109 S Crawford St, Danville, IL 61832-6418 | 2018-03-01 |
| 1659789089 | Kelly O'brien | Recreation Therapist | 1039 Forest Ave, Belleville, IL 62220-3623 | 2014-07-29 |
| 1548608169 | Deidre Omahen | Recreation Therapist | 4913 Parkway Dr, Downers Grove, IL 60515-3507 | 2013-06-05 |
| 1700113859 | Sarah Jean Ostrowski | Recreation Therapist | 2100 S 5th Ave, Hines, IL 60141 | 2009-11-11 |
| 1871820266 | Colleen Michelle Hopp | Recreation Therapist | 10535 Faust Rd, Lebanon, IL 62254-2904 | 2009-11-06 |
| 1770735433 | Mary Terese Anne Squeo | Recreation Therapist | 8626 Dunbar St, Willow Springs, IL 60480-1165 | 2008-10-14 |
| 1477728319 | Clinical Connections | Recreation Therapist | 2225 Lakeside Dr, Bannockburn, IL 60015-1265 | 2008-04-22 |
| 1386847556 | Katie Barbier | Recreation Therapist | 4150 Gatling Blvd, Country Club Hills, IL 60478-2024 | 2007-06-06 |
| 1225248412 | Karin A Huisenga | Recreation Therapist | 17843 Durkin Rd, Tinley Park, IL 60477-2153 | 2007-05-23 |
| Find all providers with the same taxonomy | ||||
| City | OAK FOREST |
| Zip Code | 60452 |
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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.