Cindy Lee Bertolino, NP
Individual provider Active NPI Family Nurse Practitioner · Mount Olive, IL
NPI 1386145258 · NPPES record last updated Jul 9, 2020
Key facts
- NPI
- 1386145258
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209.017490 (IL)
- Practice address
- 9142 Prospect Rd
Mount Olive, IL 62069-2334 - Phone
- (217) 556-5806
- Fax
- (217) 556-5806
- NPI assigned
- Feb 26, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Toofan Medical Holdings, LTD
Practice addresses (Care Compare)
1001 Ave of Mid America
Suite 4
Effingham, IL 62401-4634
Phone (217) 994-9301
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200721003549 | IL | Practitioner - Nurse Practitioner | 5193149318 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.017490 | IL | MD | Family Nurse Practitioner |
| F02180041 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Toofan Medical Holdings, LTD. | Current |
Accepting new patients | |
| Toofan Medical Holdings, LTD | Current |
Accepting new patients |
Locations
1001 Avenue of Mid America
Ste 4
Effingham, IL 62401
Phone (217) 994-9301
1001 Avenue of Mid America
Effingham, IL 62401
Phone (733) 593-1701
20 Corvette Dr
Litchfield, IL 62056
20 Corvette Dr
Ste A
Litchfield, IL 62056
Phone (217) 994-9301
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F02180041 | MO | |
| Family Nurse Practitioner | 363LF0000X | 209.017490 | IL | Yes |
Addresses
Primary practice location
9142 Prospect Rd
Mount Olive, IL 62069-2334
Mailing address
9142 Prospect Rd
Mount Olive, IL 62069-2334
Phone (217) 556-5806
Other providers in Mount Olive, IL
- Advanced Family Dental & Orthodontics of Mt. Olive, P.C.
- Ageless RX Systems LLC
- Brooke A Borrowman
- Catherine A Brister
- Dennis J. Guardia
- Brandi Lynn Kelly
- Locust Street Resource Center Cila #2
All providers in Mount Olive, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.