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General NPI Number Information
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NPI Number | 1538224118
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Entity Type | Organization
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Legal Business Name | JEFFREY K . BERGIN, DC, DABCI, SC
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 12/20/2008
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Provider Practice Location Address
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Address Line | 2629 SHERIDAN RD SUITE 1A
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City | ZION
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State | IL
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Zip | 60099-2629
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Country | US
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Telephone | 847-872-8230
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Fax | 847-872-8208
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Provider Business Mailing Address
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Address Line | 2629 SHERIDAN RD SUITE 1A
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City | ZION
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State | IL
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Zip | 60099-2629
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Country | US
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Telephone | 847-872-8230
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Fax | 847-872-8208
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY KEITH BERGIN
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Credential | D.C.
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Telephone | 847-872-8230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NI0900X
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Taxonomy Name | Internist Chiropractor
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License Number | 038-004780
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License Number State | IL
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