Individual
DR. BERNARD R BACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1611 W HARRISON ST, # 400, CHICAGO, IL 60612-3841
(312) 243-4244
(312) 942-1517
Mailing address
1 WESTBROOK CORPORATE CTR, #240, WESTCHESTER, IL 60154-5701
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
036073187
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036073187
—
IL
01
—
1633878
BCBS
IL
01
—
207067
MEDICARE PTAN LOCALITY 16
IL
01
—
207073
MEDICARE PTAN LOCALITY 15
IL
01
—
4028377
AETNA
—
01
—
DA4902
RAILROAD MEDICARE PTAN
—
01
—
P00095130
RAILROAD MEDICARE
—
Enumeration date
01/10/2006
Last updated
09/19/2018
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