MEDICARE: KIMBERLY A. BERKI PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	085-001665	IL
2	363AS0400X	Surgical Physician Assistant	085001665	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00293352	OTHER	IL	MEDICARE RAILROAD

General Provider Information

NPI Number	:	1154397636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY A. BERKI PA-C

Provider Business Mailing Address
First Line	:	2650 RIDGE AVE STE 1223
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1700
Country	:	US
Telephone Number	:	847-570-2040
Fax Number	:

Provider Business Practice Location Address
First Line	:	9600 GROSS POINT RD
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60076-1214
Country	:	US
Telephone Number	:	847-933-6550
Fax Number	:	847-933-6260

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	02/10/2026

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Directions to “ KIMBERLY A. BERKI PA-C” Practice Location

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