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NPI Code Detail

MEDICARE: DR. J. BRADFORD HAMPSHIRE BERTUMEN M.D.

MEDICARE: DR. J. BRADFORD HAMPSHIRE BERTUMEN 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
1207RI0200XInfectious Disease Physician036141514IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558681577
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. J. BRADFORD HAMPSHIRE BERTUMEN M.D.
Provider Business Mailing Address
First Line : 901 MCCLINTOCK DR
Second Line : STE 202
City : BURR RIDGE
State : IL
Zip : 60527-0871
Country : US
Telephone Number : 888-220-6432
Fax Number : 630-734-4715
Provider Business Practice Location Address
First Line : 13755 CICERO AVE
Second Line :
City : CRESTWOOD
State : IL
Zip : 60418-1824
Country : US
Telephone Number : 708-385-2400
Fax Number : 708-385-2434
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2010
Last Update Date : 10/23/2017

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