Individual
DR. JEFFREY KEITH BERGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC, DABCI
Contact information
Practice address
2629 SHERIDAN RD, SUITE 1A, ZION, IL 60099-2629
(847) 872-8230
(847) 872-8208
Mailing address
2629 SHERIDAN RD, SUITE 1A, ZION, IL 60099-2629
(847) 872-8230
(847) 872-8208
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
Primary
038-004780
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
743871001
MEDICARE PTAN
IL
Enumeration date
04/07/2006
Last updated
12/20/2008
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