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NPI Code Detail

MEDICARE: CAROLINE BERNARDI

MEDICARE: CAROLINE BERNARDI
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
1363LF0000XFamily Nurse Practitioner209021069IL

General Provider Information

NPI Number : 1912525544
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLINE BERNARDI
Provider Business Mailing Address
First Line : 1203 W AUGUSTA BLVD STE 1
Second Line :
City : CHICAGO
State : IL
Zip : 60642-4327
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1203 W AUGUSTA BLVD STE 1
Second Line :
City : CHICAGO
State : IL
Zip : 60642-4327
Country : US
Telephone Number : 773-248-2255
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2020
Last Update Date : 01/29/2024

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Directions to “ CAROLINE BERNARDI ” Practice Location

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