Individual
MICHAEL A BERGOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1414 CROSS STREET, SUITE 330, SHILOH, IL 62269-2998
(618) 277-7400
(618) 277-7422
Mailing address
1414 CROSS STREET, SUITE 330, SHILOH, IL 62269-2998
(618) 277-7400
(618) 277-7422
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036153202
IL
208600000X
Surgery Physician
45795
WI
Other
Enumeration date
07/17/2006
Last updated
03/20/2024
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