Individual
DR. RICHARD H BERTENSHAW JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7545 WILTON RD, DARIEN, IL 60561-6702
(708) 921-6053
(877) 992-6901
Mailing address
7545 WILTON RD, DARIEN, IL 60561-6702
(708) 921-6053
(877) 992-6901
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
036074851
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609994987
GROUP PRACTICE NPI
IL
01
—
C30167
RAILROAD MEDICARE PTAN
IL
Enumeration date
07/14/2006
Last updated
08/03/2021
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