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General NPI Number Information
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NPI Number | 1538340252
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Entity Type | Organization
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Legal Business Name | DR V PAUL BERTRAND NEUROLOGY & NE URODIAGNOSTICS LTD
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 05/20/2009
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Provider Practice Location Address
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Address Line | 655 N LAGRANGE ROAD
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City | FRANKFORT
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State | IL
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Zip | 60423
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Country | US
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Telephone | 815-469-2888
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Fax | 815-469-3697
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Provider Business Mailing Address
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Address Line | 655 N LAGRANGE ROAD
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City | FRANKFORT
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State | IL
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Zip | 60423
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Country | US
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Telephone | 815-469-2888
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Fax | 815-469-3697
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Authorized Official
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Title or Position | NEUROLOGIST
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Name | VOLKER PAUL BERTRAND
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Credential | DO
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Telephone | 815-469-2888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 036059245
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License Number State | IL
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