| Doctor Name: | DR. BERNARDINO MICHAEL MENDEZ |
| NPI Number: | 1114216363 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | M53207384272 |
| Business Practice Address: | 2160 S 1st Ave Ems Building, Room 3212 Maywood, IL - 601533328 |
| Business Phone Number: | 7083273436 |
| Business Fax Number: | 7083273489 |
| Mailing Address: | 7753 Van Buren St, Unit 511 FOREST PARK |
| State: | IL |
| Postal Code: | 601301887 |
| Phone Number: | 6306511115 |
| Fax Number: | |
| NPI Enumeration Date: | 03/28/2011 |
| NPI Last Update Date: | 04/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | M53207384272 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |