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Individual

DR. GABRIEL IRA BERLIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3633 W LAKE AVE, SUITE 302, GLENVIEW, IL 60026-5805
(847) 998-5700
(847) 998-5795
Mailing address
3633 W LAKE AVE, SUITE 302, GLENVIEW, IL 60026-5805
(847) 998-5700
(847) 998-5795

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-053249
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
016-06 75-012-5 I.M.
AMA EDUCATION NUMBER
01
01638042
BLUE CROSS/BLUE SHIELD
IL
05
036053249
IL
Enumeration date
09/17/2006
Last updated
08/18/2008
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