MEDICARE: PAUL M. BERKOWITZ, M.D., S.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	36-098596	IL

General Provider Information

NPI Number	:	1922031707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL M. BERKOWITZ, M.D., S.C.

Provider Business Mailing Address
First Line	:	707 LAKE COOK RD
Second Line	:	SUITE 135
City	:	DEERFIELD
State	:	IL
Zip	:	60015-5613
Country	:	US
Telephone Number	:	847-480-3010
Fax Number	:

Provider Business Practice Location Address
First Line	:	707 LAKE COOK RD
Second Line	:	SUITE 135
City	:	DEERFIELD
State	:	IL
Zip	:	60015-5613
Country	:	US
Telephone Number	:	847-480-3010
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PAUL M. BERKOWITZ
Credential	:	M.D.
Telephone Number	:	847-480-3010

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	08/22/2020

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