Active NPI
Teresa Elaine Berry, MD
- Pediatric Cardiology Physician
- Evanston, IL
National Provider Identifier
1689481467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- 036.054139
- Practice address
- 2119 Livingston St
Evanston, IL 60201-1428 - Phone
- (847) 475-5402
- NPI assigned
- Dec 16, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Cardiology Physician | 2080P0202X | 036.054139 | IL | Primary |
Addresses
Primary practice location
2119 Livingston St
Evanston, IL 60201-1428
Mailing address
2119 Livingston St
Evanston, IL 60201-1428
Phone (847) 475-5402
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.054139 | IL | MD | Pediatric Cardiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734307200000",
"number": "1689481467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2119 LIVINGSTON ST",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011428",
"telephone_number": "847-475-5402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2119 LIVINGSTON ST",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011428",
"telephone_number": "847-475-5402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRY",
"first_name": "TERESA",
"middle_name": "ELAINE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-12-16",
"last_updated": "2024-12-16",
"certification_date": "2024-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "IL",
"license": "036.054139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.