Provider Demographics
NPI:1992151666
Name:BLOSSOM THERAPY INC
Entity type:Organization
Organization Name:BLOSSOM THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS OTR/L
Authorized Official - Phone:773-895-3477
Mailing Address - Street 1:1800 W ROSCOE ST
Mailing Address - Street 2:APT 206
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-1049
Mailing Address - Country:US
Mailing Address - Phone:773-895-3477
Mailing Address - Fax:800-686-7166
Practice Address - Street 1:1800 W ROSCOE ST
Practice Address - Street 2:APT 206
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-1049
Practice Address - Country:US
Practice Address - Phone:773-895-3477
Practice Address - Fax:800-686-7166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty