MEDICARE: MR. VALENTIN BERMAN M.D.P.C.

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	036081190	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	31604167	OTHER	IL	BLUE CROSS BLUE SHIELD ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750428967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VALENTIN BERMAN M.D.P.C.

Provider Business Mailing Address
First Line	:	3711 N PINE GROVE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-4121
Country	:	US
Telephone Number	:	773-914-0753
Fax Number	:

Provider Business Practice Location Address
First Line	:	3711 PINE GROVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613
Country	:	US
Telephone Number	:	773-914-0753
Fax Number	:	708-499-3515

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	05/12/2022

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