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NPI Code Detail

MEDICARE: DON EDWARD BERTSCHI C.R.N.A.

MEDICARE: DON EDWARD BERTSCHI C.R.N.A.
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
1367500000XCertified Registered Nurse Anesthetist209000654IL

General Provider Information

NPI Number : 1548246424
Entity Type Code : Individual
Provider Name (Legal Business Name) : DON EDWARD BERTSCHI C.R.N.A.
Provider Business Mailing Address
First Line : 2 GOOD SAMARITAN WAY STE 205
Second Line :
City : MOUNT VERNON
State : IL
Zip : 62864-2476
Country : US
Telephone Number : 618-899-3869
Fax Number : 618-899-3558
Provider Business Practice Location Address
First Line : 8 DOCTORS PARK RD
Second Line :
City : MOUNT VERNON
State : IL
Zip : 62864-6224
Country : US
Telephone Number : 618-241-8594
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2005
Last Update Date : 10/21/2020

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