MEDICARE: DR. JENNIFER ROBINS BERNSTEIN M.D.

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
1	2084P0800X	Psychiatry Physician	254516	NY
2	2084P0800X	Psychiatry Physician	036148991	IL

General Provider Information

NPI Number	:	1467612234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER ROBINS BERNSTEIN M.D.

Provider Business Mailing Address
First Line	:	2835 N SHEFFIELD AVE STE 207
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-5083
Country	:	US
Telephone Number	:	312-379-9737
Fax Number	:	435-393-2424

Provider Business Practice Location Address
First Line	:	2835 N SHEFFIELD AVE STE 207
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-5083
Country	:	US
Telephone Number	:	312-379-9737
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2008
Last Update Date	:	02/21/2022

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