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General NPI Number Information
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NPI Number | 1164525275
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Entity Type | Individual
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Provider Name | BERNARDO DUARTE M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 10/09/2015
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Provider Practice Location Address
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Address Line | 1841 W. ARMY TRAIL RD
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City | CHICAGO
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State | IL
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Zip | 60101
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Country | US
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Telephone | 630-472-1111
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Fax | 773-564-5186
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Provider Business Mailing Address
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Address Line | PO BOX 2143
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-8143
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Country | US
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Telephone | 630-472-1111
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Fax | 630-472-1125
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 036047859
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | 036047859
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License Number State | IL
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