Laura Bergeron, DPT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

070020207 Issued in IL

Practice address

6801 High Grove Blvd
Burr Ridge, IL 60527-7585

Phone

(630) 920-2900

NPI assigned

Nov 23, 2021

Last updated

Nov 23, 2021By 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 1

Addresses

Other identifiers 1

Other names 1

• Laura Anderson Former name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Oasis Therapy Services LLC

  • Multi-Specialty Clinic/Center
  • Oshkosh, WI
  • NPI 1386381598

  IL

  Medicare reassignment

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1235896473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 GREENSBORO DR",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601898131",
            "telephone_number": "847-452-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 HIGH GROVE BLVD",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605277585",
            "telephone_number": "630-920-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "LAURA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-23",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "IL",
            "license": "070020207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION",
            "identifier": "070020207",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "ANDERSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maryam Beilani
• Hannah Ashenafi Belay, MA
• Jaime Belmares Avalos, MD
• Ruby Beltran, OTR/L
• Nicola Bennett, APNP
• Elizabeth Valencia Bernardino, M.D.
• Eric C Beyer, MD
• Bioconcepts Inc
• Roderick R Birnie, MD
• Krystina Blas, FNP

• Geriatric Physical Therapist in Burr Ridge, IL
• Providers in Burr Ridge, IL by specialty
• Geriatric Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.