Individual
BRUCE A. BERGELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9650 GROSS POINT RD STE 4900, SKOKIE, IL 60076
(847) 864-3278
(847) 676-1727
Mailing address
9650 GROSS POINT RD STE 4900, SKOKIE, IL 60076-1214
(847) 864-3278
(847) 676-1727
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036082701
IL
207RC0000X
Cardiovascular Disease Physician
Primary
036082701
IL
207RI0011X
Interventional Cardiology Physician
036082701
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36082701
—
IL
Enumeration date
08/31/2006
Last updated
12/08/2020
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