MEDICARE: CHRISTOPHER J BERGIN MD

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	207XS0117X	Orthopaedic Surgery of the Spine Physician	036-097991	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205880820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER J BERGIN MD

Provider Business Mailing Address
First Line	:	1875 DEMPSTER ST
Second Line	:	STE 425
City	:	PARK RIDGE
State	:	IL
Zip	:	60068-1129
Country	:	US
Telephone Number	:	847-298-7024
Fax Number	:	847-298-7155

Provider Business Practice Location Address
First Line	:	1875 DEMPSTER ST
Second Line	:	STE 425
City	:	PARK RIDGE
State	:	IL
Zip	:	60068-1129
Country	:	US
Telephone Number	:	847-698-9330
Fax Number	:	847-698-9198

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	11/06/2019

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