Stephen K Bergman, CRNA ARN
Individual provider Active NPI Certified Registered Nurse Anesthetist · Carthage, IL
NPI 1891781258 · NPPES record last updated Apr 28, 2008
Key facts
- NPI
- 1891781258
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 209000387 (IL)
- Practice address
- 402 S Adams St
Carthage, IL 62321-1600 - Phone
- (217) 357-3131
- Fax
- (217) 357-6564
- NPI assigned
- Sep 21, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041149504 | IL | MD | Registered Nurse |
| 209000387 | IL | MD | Certified Registered Nurse Anesthetist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041149504 | IL | |
| Certified Registered Nurse Anesthetist | 367500000X | 209000387 | IL | Yes |
Addresses
Primary practice location
402 S Adams St
Carthage, IL 62321-1600
Mailing address
PO Box 160
Carthage, IL 62321-0160
Phone (217) 357-3131
Other providers in Carthage, IL
- Jennifer Kruse Allen
- Krista Artman
- Sara Barker
- Kolina Arlene Baucom
- Tracey Lynn-Severt Behymer
- Curtis Bisby
- Melissa K Brewer
- Rodney Brumley
- George Brummell
- Lindsay Brummell
All providers in Carthage, IL · Certified Registered Nurse Anesthetist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2008. 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.