Individual provider Active NPI

Valentin Berman, M.D.P.C.

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1750428967
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036081190 Issued in IL
Practice address
3711 Pine Grove
Chicago, IL 60613
Phone
(773) 914-0753
Fax
(708) 499-3515
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036081190 IL Primary

Addresses

Primary practice location

3711 Pine Grove
Chicago, IL 60613

Mailing address

3711 N Pine Grove Ave
Chicago, IL 60613-4121
Phone (773) 914-0753

Other practice location 1

228 E Lake St
Addison, IL 60101-2889
Phone (630) 835-1430

Other identifiers 2

IdentifierTypeStateIssuer
31604167OtherILBLUE CROSS BLUE SHIELD ID
036081190MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081213000152 IL Practitioner - Psychiatry 8022028422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Rush Medical College of Rush University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valentin Berman MD PCGroup PAC ID 6406866896, 2 clinicians

Practice addresses (Care Compare)

10801 S Western Ave
Suite 2B
Chicago, IL 60643-3225
Phone (708) 499-3525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036081190ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valentin Berman MD PC Psychiatry CurrentSince Oct 1, 1999 Accepting new patients
Mirjam Quinn and Associates, LTD CurrentSince Oct 17, 2023 Accepting new patients

Locations

10801 S Western Ave
Ste 2B
Chicago, IL 60643
Phone (708) 499-3525

2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153

Interoperability endpoints

  • Direct secure messaging: valentin.berman.2@29472.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1750428967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 N PINE GROVE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134121",
            "telephone_number": "773-914-0753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 PINE GROVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60613",
            "telephone_number": "773-914-0753",
            "fax_number": "708-499-3515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "228 E Lake St",
            "address_purpose": "LOCATION",
            "city": "Addison",
            "state": "IL",
            "postal_code": "601012889",
            "country_code": "US",
            "telephone_number": "630-835-1430",
            "fax_number": "630-835-1433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "VALENTIN",
        "name_prefix": "Mr.",
        "credential": "M.D.P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036081190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "31604167",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036081190",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.