Provider Demographics
NPI:1598360091
Name:BLOOMING PEDIATRIC THERAPIES
Entity Type:Organization
Organization Name:BLOOMING PEDIATRIC THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JANOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-791-5517
Mailing Address - Street 1:106 W MARGARET TER
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-2156
Mailing Address - Country:US
Mailing Address - Phone:847-791-5517
Mailing Address - Fax:224-333-6706
Practice Address - Street 1:106 W MARGARET TER
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:IL
Practice Address - Zip Code:60013-2156
Practice Address - Country:US
Practice Address - Phone:847-791-5517
Practice Address - Fax:224-333-6706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational MedicineGroup - Multi-Specialty