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General NPI Number Information
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NPI Number | 1568543577
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Entity Type | Organization
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Legal Business Name | HARVEY BERLIN MD SC
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 09/11/2007
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Provider Practice Location Address
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Address Line | 111 N WABASH AVE 1008
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City | CHICAGO
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State | IL
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Zip | 60602-1903
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Country | US
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Telephone | 312-346-5737
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Fax | 312-346-8533
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Provider Business Mailing Address
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Address Line | 111 N WABASH AVE 1008
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City | CHICAGO
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State | IL
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Zip | 60602-1903
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Country | US
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Telephone | 312-346-5737
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Fax | 312-346-8533
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. HARVEY W BERLIN
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Credential | MD
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Telephone | 312-346-5737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036-052948
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License Number State | IL
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