Doctor Name: | LINDA MAE BERNARD |
NPI Number: | 1235184938 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | 209000954 |
Business Practice Address: | 7411 West Lake L-120 River Forest, IL - 603051806 |
Business Phone Number: | 7084881919 |
Business Fax Number: | 7084882370 |
Mailing Address: | 7411 West Lake, L-120 RIVER FOREST |
State: | IL |
Postal Code: | 603051806 |
Phone Number: | 7084881919 |
Fax Number: | 7084882370 |
NPI Enumeration Date: | 05/23/2006 |
NPI Last Update Date: | 12/18/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 209000954 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |