Individual
ELIZA F BERNAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 TIFFANY PT, SUITE 105, BLOOMINGDALE, IL 60108-2936
(630) 980-1400
(630) 980-1441
Mailing address
1749 PORTSMITH CT, BARTLETT, IL 60103-7412
(630) 377-7900
(630) 377-8007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036088229
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0222075
BLUE CROSS GROUP NUMBER
IL
05
—
036088229
—
IL
01
—
363149833
TAX IDENTIFICATION NUMBER
IL
01
—
3631498336019001
CDPG HFS PAYEE ID
IL
Enumeration date
06/28/2006
Last updated
10/01/2014
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