Individual
MOLLY ANNE BERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2512
(217) 383-3364
(217) 383-4372
Mailing address
611 W PARK ST, URBANA, IL 61801-2512
(217) 383-3364
(217) 383-4372
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007016
IL
363A00000X
Physician Assistant
090482
IA
363A00000X
Physician Assistant
—
—
Other
Enumeration date
02/09/2018
Last updated
04/20/2020
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