Allen C Bernthal M D Ltd
Specialist in Berwyn, IL. Organization (NPI-2).
NPI number1366763534
StatusActive
Last updated in NPPESSep 30, 2010
Details
- NPI
- 1366763534
- Entity type
- Organization (NPI-2)
- Legal business name
- Allen C Bernthal M D Ltd
- Organization subpart
- No
- Enumeration date
- Jun 22, 2010
- Last updated
- Sep 30, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 036054138 | IL | Yes |
Practice location
6827 Stanley AveBerwyn, IL 60402-3287
Phone 708-749-4617 · Fax 708-749-0094
Mailing address
6827 Stanley AveBerwyn, IL 60402-3287
Phone 708-749-4617 · Fax 708-749-0094
Authorized official
Allen C Bernthal
President
7087494617
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