J.E. Bertolini MD, S.C.

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

J.E. BERTOLINI MD, S.C.

Practice address

202 N Hammes Ave
Suite D
Joliet, IL 60435-8129

Phone

(815) 741-4104

NPI assigned

Sep 28, 2011

Last updated

Sep 28, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

J.E. BERTOLINI MD, S.C.As reported in NPPES

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

Authorized official

Name

Jerry Bertolini, MDNPI 1407950116

Title

President

Phone

(815) 741-4104

Specialties & licenses 1

Addresses

Part of

Jebertolini MD SC

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerry E Bertolini, MD

  • Orthopaedic Surgery Physician
  • Joliet, IL
  • NPI 1407950116
  NPD (past) Authorized official
• Eileen E. Heffernan, M.D.

  • Family Medicine Physician
  • Joliet, IL
  • NPI 1609862382
  NPD (past)
• Iwona Laciak, P.T.

  • Physical Therapist
  • Homer Glen, IL
  • NPI 1093983751
  NPD (past)

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

{
    "created_epoch": "1317168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317168000000",
    "number": "1245513076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "SUITE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771726",
            "telephone_number": "310-474-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N HAMMES AVE",
            "address_2": "SUITE D",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358129",
            "telephone_number": "815-741-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J.E. BERTOLINI MD, S.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "J.E. BERTOLINI MD, S.C.",
        "enumeration_date": "2011-09-28",
        "last_updated": "2011-09-28",
        "status": "A",
        "authorized_official_last_name": "BERTOLINI",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-741-4104",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Issan Health Care Group LTD
• Tracey Ivan
• Iyad Awadallah DMD PC
• J D Brown & Co Inc (J D Brown Pharmacy)
• J D Brown & Co Inc
• J.E.Bertolini ,M.D. SC. (Advantacare)
• Nabil Jaber, MD
• Laura Jackman
• Michael Jacksa, LCPC
• Jessica Jackson, PA-C

• Non-Pharmacy Dispensing Site in Joliet, IL
• Providers in Joliet, IL by specialty
• Non-Pharmacy Dispensing Site in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; 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.