Allen C Bernthal M D LTD
Organization Active NPI Specialist · Berwyn, IL
NPI 1366763534 · NPPES record last updated Sep 30, 2010
Key facts
- NPI
- 1366763534
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 036054138 (IL)
- Legal business name
- ALLEN C BERNTHAL M D LTD
- Practice address
- 6827 Stanley Ave
Berwyn, IL 60402-3287 - Phone
- (708) 749-4617
- Fax
- (708) 749-0094
- NPI assigned
- Jun 22, 2010
- Organization subpart
- No
Authorized official
- Name
- Allen C Bernthal, M.D.
- Title
- President
- Phone
- (708) 749-4617
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 036054138 | IL | Yes |
Addresses
Primary practice location
6827 Stanley Ave
Berwyn, IL 60402-3287
Mailing address
6827 Stanley Ave
Berwyn, IL 60402-3287
Phone (708) 749-4617
Other providers in Berwyn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2010. 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.