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General NPI Number Information
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NPI Number | 1649830159
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Entity Type | Individual
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Provider Name | NATALIE BERGER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 06/17/2019
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Last Update Date | 06/17/2019
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Provider Practice Location Address
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Address Line | 1645 W JACKSON BLVD STE 203
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City | CHICAGO
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State | IL
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Zip | 60612-3227
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Country | US
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Telephone | 312-942-0819
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Fax |
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Provider Business Mailing Address
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Address Line | 1429 N PAULINA ST APT D
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City | CHICAGO
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State | IL
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Zip | 60622-2173
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Country | US
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Telephone |
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.009984
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 071.009984
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License Number State | IL
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