Individual
MR. STEPHEN K BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA ARN
Contact information
Practice address
402 S ADAMS ST, CARTHAGE, IL 62321-1600
(217) 357-3131
(217) 357-6564
Mailing address
PO BOX 160, CARTHAGE, IL 62321-0160
(217) 357-3131
(217) 357-6564
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041149504
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209000387
IL
Other
Enumeration date
09/21/2005
Last updated
04/28/2008
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