Beth M Marshall-Bergman, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036.135673 Issued in IL

Practice address

125 S Wacker Dr Ste 300
Chicago, IL 60606-4421

Phone

(617) 505-1520

Fax

(617) 928-8401

NPI assigned

Apr 4, 2011

Last updated

Jun 24, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Other names 1

• Beth M Marshall Former name

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

Specialty

Internal Medicine

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Form Health Associates Ma, P.C.Group PAC ID 3375953961, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: beth.bergman@168064768409604.direct.elationemr.com
• Direct secure messaging: bmarshallbergman17846@direct.rush.rush-health.com

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

• Form Health Associates Ma, P.C.

  • Endocrinology, Diabetes & Metabolism Physician
  • Boston, MA
  • NPI 1386260594

  IL

  Medicare reassignment Care Compare group NPD
• Rush Oak Park Physicians Group Adult Medicine

  • Adult Medicine Physician
  • Oak Park, IL
  • NPI 1548531924

  Internal Medicine

  Medicare reassignment NPD
• Rush Oak Park Physicians Group Center for Diabetes and Endocrine

  • Endocrinology, Diabetes & Metabolism Physician
  • Oak Park, IL
  • NPI 1841560141
  Medicare reassignment NPD

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1962791657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 STATE ST STE 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021092906",
            "telephone_number": "617-505-1520",
            "fax_number": "617-928-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S WACKER DR STE 300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606064421",
            "telephone_number": "617-505-1520",
            "fax_number": "617-928-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL-BERGMAN",
        "first_name": "BETH",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "4856",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "3894",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "C0750",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.135673",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "2877",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "EMC0001956",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "30199",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "91988",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "MARSHALL",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marshall I Matz & David M Shenker MDSC
• Marshall I Matz MD SC
• Marshall Psychotherapy PLLC
• Marshall S. Olech, DDS,PC
• Marshall Sparberg, MD, LTD
• Carly Ann Marshall-Braun, CPM
• Allison Dyer Marshall, DPT
• Amy Marshall, MS
• Ashley Marshall
• Audrey Marshall

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.