MEDICARE: JOSHUA BERLIANT

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	332B00000X	Durable Medical Equipment & Medical Supplies	271188175	IL

General Provider Information

NPI Number	:	1831425750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA BERLIANT

Provider Business Mailing Address
First Line	:	2451 W MOFFAT ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-4310
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2451 W MOFFAT ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-4310
Country	:	US
Telephone Number	:	773-278-7500
Fax Number	:	773-342-2229

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

Provider Enumeration Date	:	10/28/2009
Last Update Date	:	10/28/2009

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Directions to “ JOSHUA BERLIANT ” Practice Location

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