Susan Berg, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036133526 Issued in IL

Practice address

311 W. Fairchild
Danville, IL 61832-3876

Phone

(217) 431-7650

NPI assigned

Jul 15, 2005

Last updated

Dec 9, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Parkway Regional Medical Clinic Inc

  • Family Medicine Physician
  • Fulton, KY
  • NPI 1659370153
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386547200000",
    "number": "1043219736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6002",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618036002",
            "telephone_number": "217-326-8630",
            "fax_number": "615-309-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W. FAIRCHILD",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323876",
            "telephone_number": "217-431-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2013-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "38999",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036133526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Patricia Becker, RN, MSN, FNP-BC
• Brittany Michelle Bedford
• Behold Star Eyes Limited Liability Company Utang Ekpo Sole MBR
• Jean Marie Bell, PHARMACIST
• Jeremy N Bell, BSW
• Nadia C Berger, MSW
• Milia Beth Bergkoetter, MS MFCC LCPC
• Cicero Offemaria Bermundo
• Brie Morgan Bertges, QMHP, LPC, CADC
• Lindsey Betout, APRN

• Family Medicine Physician in Danville, IL
• Providers in Danville, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.