Bergen, Donna C

Bergen, Donna C is an individual health care provider with primary practice located at 1725 W Harrison St 1106, Chicago IL 60612-3841. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Clinical Neurophysiology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Bergen, Donna C can be contacted via phone (312) 942-5936.

Contact Information

Primary practice address
1725 W Harrison St 1106 Chicago IL 60612-3841
Phone: (312) 942-5936
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 036045728 Illinois
Allopathic & Osteopathic Physicians / Clinical Neurophysiology 2084N0600X 036045728 Illinois

Profile Details

NPI number 1548256357
LBN Legal business name Bergen, Donna C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2005
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548256357 NPPES
Illinois Other 336012506 CONTROLLED
Illinois MEDICAID 036045728 CONTROLLED

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