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NPI Code Detail

MEDICARE: BERNADINE ESPIRITU BERRIDGE MD

MEDICARE: BERNADINE ESPIRITU BERRIDGE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician036128767IL
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1437322195
Entity Type Code : Individual
Provider Name (Legal Business Name) : BERNADINE ESPIRITU BERRIDGE MD
Provider Business Mailing Address
First Line : 1817 S LOOMIS ST
Second Line :
City : CHICAGO
State : IL
Zip : 60608-3018
Country : US
Telephone Number : 312-666-6511
Fax Number : 312-666-1658
Provider Business Practice Location Address
First Line : 1817 S LOOMIS ST
Second Line :
City : CHICAGO
State : IL
Zip : 60608-3018
Country : US
Telephone Number : 312-666-6511
Fax Number : 312-666-1658
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2008
Last Update Date : 12/06/2021

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