Individual
DR. MICHAEL H BERKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 PARK AVE E STE 306, PRINCETON, IL 61356-3903
(815) 876-3099
(815) 876-3003
Mailing address
530 PARK AVE E, PRINCETON, IL 61356
(815) 875-2811
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036-052590
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036052590
—
IL
01
—
0451517835
BLUE SHIELD
—
01
—
200008160
RR MEDICARE
—
01
—
791203314
RR MEDICARE
—
Enumeration date
07/19/2005
Last updated
12/09/2020
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