Sue Bergstrom

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.000404 Issued in IL

Practice address

263 Grand Ridge Rd
Saint Charles, IL 60175-1074

Phone

(630) 762-9984

NPI assigned

Jun 16, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1861873705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 GRAND RIDGE RD",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601751074",
            "telephone_number": "630-762-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 GRAND RIDGE RD",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601751074",
            "telephone_number": "630-762-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "SUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.000404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hayley Valene Belina, APRN
• Genevieve Belt, L.AC.
• Anna Benesiewicz, ACNP-BC
• Jennifer Berg
• Robert Berg
• Autumn E Bernicky, DO
• Kimberly Berry
• Andrew Evo Bertagna, DMD, MD
• Charles E. W. Berthold, PH.D.
• Brenda Lee Bertrand, RN

• Speech-Language Pathologist in St Charles, IL
• Providers in St Charles, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.