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General NPI Number Information
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NPI Number | 1740410976
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Entity Type | Organization
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Legal Business Name | JANA BERGFELD LCSW, P.C
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Dates
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Enumeration Date | 07/22/2009
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Last Update Date | 07/22/2009
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Provider Practice Location Address
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Address Line | 501 W. OGDEN AVENUE SUITE 1
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City | HINSDALE
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State | IL
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Zip | 60521
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Country | US
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Telephone | 708-373-5959
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Fax | 630-986-1477
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Provider Business Mailing Address
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Address Line | 501 W. OGDEN AVENUE SUITE 1
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City | HINSDALE
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State | IL
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Zip | 60521
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Country | US
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Telephone | 708-373-5959
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Fax | 630-986-1477
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | JANA L. BERGFELD
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Credential | MSW, LCSW
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Telephone | 708-373-5959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.009713
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License Number State | IL
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