Bergin, Jeffrey Keith
Bergin, Jeffrey Keith is an individual health care provider with primary practice located at 2629 Sheridan Rd Suite 1A, Zion IL 60099-2629. He recently has only one registered license in Chiropractic Providers / Internist, which is considered as his primary health care specialty. Bergin, Jeffrey Keith can be contacted via phone (847) 872-8230.Contact Information
Primary practice address
2629 Sheridan Rd Suite 1A
Zion IL 60099-2629
Phone: (847) 872-8230
Fax: (847) 872-8208
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Internist | 111NI0900X | 038-004780 | Illinois |
Profile Details
| NPI number | 1265495675 |
|---|---|
| LBN Legal business name | Bergin, Jeffrey Keith |
| Credentials | DC, DABCI |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 7th, 2006 |
| Last updated | Dec 20th, 2008 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265495675 | NPPES |
| Illinois | Other | 743871001 | MEDICARE PTAN |
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