Alejandro B Bernal, MD
Individual provider Active NPI Family Medicine Physician · Peru, IL
NPI 1346253630 · NPPES record last updated Aug 25, 2008
Key facts
- NPI
- 1346253630
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036048248 (IL)
- Practice address
- 1515 36TH Street
Peru, IL 61354 - Phone
- (815) 223-4550
- Fax
- (815) 223-6806
- NPI assigned
- Aug 15, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036048248 | IL | Yes |
Addresses
Primary practice location
1515 36TH Street
Peru, IL 61354
Mailing address
600 E 1St St
Spring Valley, IL 61362-1512
Phone (815) 223-4550
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036048248 | Medicaid | IL |
Other providers in Peru, IL
- Jane Battles
- Mida N Bautista-Dittmar
- Tamara Leigh Beaber
- Kami Lynn Becker
- Angela Benavides
- Sondra L Blocki
- Shyrlena L Bogard
- Amy Lynn Bolelli
- Joan Elizabeth Boska
- David Bourbonnais
All providers in Peru, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.