Mitchell Harris Bershader, PT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

05005847A Issued in IN

Practice address

6931 North Ave
Oak Park, IL 60302-1053

Phone

(708) 763-0580

NPI assigned

Jul 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Chicago PT Management, Inc.

  • Rehabilitation Clinic/Center
  • Skokie, IL
  • NPI 1518174705

  Physical Medicine & Rehabilitation

  NPD (past)
• Physicians for Natural Healing and Rehabilitation

  • Chiropractor
  • Prospect Heights, IL
  • NPI 1962658328
  NPD (past)
• R&R Global Chiropractic Clinic, P.C.

  • Chiropractor
  • Oak Park, IL
  • NPI 1447450242
  NPD (past)

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1134328024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6931 NORTH AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021053",
            "telephone_number": "708-763-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6931 NORTH AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021053",
            "telephone_number": "708-763-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERSHADER",
        "first_name": "MITCHELL",
        "middle_name": "HARRIS",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "05005847A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200868480",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD",
            "identifier": "000000533922",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "05005847A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD",
            "identifier": "000000524384",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Z. Berman, MSW, LCSW
• Teresita Bernabe
• Constance Lynn Bernt, PSY.D.
• Jorge Antonio Berrios, PHARM.D.
• Heaven Tamira Berry
• Bertini Pharmaceutical Services Inc
• Kenneth Robert Bertini, RPH
• Gabriela Betancourt
• Beth Dodge, Inc.
• Better Communities LLC

• Physical Medicine & Rehabilitation Physician in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Physical Medicine & Rehabilitation Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; 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.