MEDICARE: ROBERT T BERNAT 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	207W00000X	Ophthalmology Physician	036096460	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	336-065106	OTHER	IL	IL CONTROLLED SUBSTANCE
2	036096460	OTHER	IL	IL LICENSE

General Provider Information

NPI Number	:	1720304876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT T BERNAT MD

Provider Business Mailing Address
First Line	:	120 S LASALLE ST
Second Line	:	SUITE 1600
City	:	CHICAGO
State	:	IL
Zip	:	60603-3403
Country	:	US
Telephone Number	:	312-859-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2507 W CERMAK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-3719
Country	:	US
Telephone Number	:	773-523-3086
Fax Number	:

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

Provider Enumeration Date	:	04/14/2010
Last Update Date	:	03/07/2023

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