Provider Demographics
NPI:1285462960
Name:BLUMER PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:BLUMER PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-220-7631
Mailing Address - Street 1:2025 PRAIRIE ST
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-2824
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 CENTRAL AVE STE 320
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-3024
Practice Address - Country:US
Practice Address - Phone:847-220-7631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty