Healthcare Provider Details

I. General information

NPI: 1699751628
Provider Name (Legal Business Name): ARNOLD STEVEN BERNS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 01/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2277 W HOWARD ST
CHICAGO IL
60645-1922
US

IV. Provider business mailing address

1101 S CANAL ST
CHICAGO IL
60607-4901
US

V. Phone/Fax

Practice location:
  • Phone: 773-508-0110
  • Fax: 773-508-0074
Mailing address:
  • Phone: 312-986-0110
  • Fax: 312-663-1010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number036046704
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: