BRUCE A. BERGELSON (NPI# 1780795724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780795724 |
| Entity Type | Individual |
| Full Name | BRUCE A. BERGELSON |
| Credential | MD |
| Practice Address |
9650 Gross Point Rd Ste 4900 Skokie IL 60076 |
| Mailing Address |
9650 Gross Point Rd Ste 4900 Skokie IL 60076-1214 |
| Practice Telephone | 8478643278 |
| Practice Fax Number | 8476761727 |
| Mailing Telephone | 8478643278 |
| Mailing Fax Number | 8476761727 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-04-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 036082701 | IL | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
036082701 | IL | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
036082701 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 36082701 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9669 Kenton Ave, Suite 206, Skokie, IL 600761266 | 8476761333 | 8476761727 |
| Street Address |
9650 GROSS POINT RD STE 4900 |
| City | SKOKIE |
| State | IL |
| Zip Code | 60076 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841286770 | David I. Koenigsberg | Internal Medicine | 9650 Gross Point Rd Ste 4900, Skokie, IL 60076 | 2005-09-26 |
| 1134696628 | Heather Marie Kotowicz | Nurse Practitioner | 9650 Gross Point Rd Ste 4900, Skokie, IL 60076-1214 | 2018-11-01 |
| 1568759272 | Mohd Arman Qamar | Internal Medicine | 9650 Gross Point Rd Ste 4900, Skokie, IL 60076-5080 | 2011-07-01 |
| 1841502028 | Kambiz Zorriasateyn | Internal Medicine | 9650 Gross Point Rd Ste 4900, Skokie, IL 60076-1214 | 2010-07-05 |
| 1598886368 | Alfonso Javier Tafur | Internal Medicine | 9650 Gross Point Rd Ste 4900, Skokie, IL 60076 | 2007-04-02 |
| 1285778472 | Abed E. Dehnee | Internal Medicine | 9650 Gross Point Rd Ste 4900, Skokie, IL 60076-5080 | 2007-02-19 |
| 1255471140 | Boruch Zucker | Internal Medicine | 9650 Gross Point Rd Ste 4900, Skokie, IL 60076 | 2007-02-08 |
| 1699851915 | Cheong Jun Lee | Surgery | 9650 Gross Point Rd Ste 4900, Skokie, IL 60076-1214 | 2006-10-29 |
| 1629150768 | Gregory J Mishkel | Internal Medicine | 9650 Gross Point Rd Ste 4900, Skokie, IL 60076 | 2006-10-19 |
| 1295846251 | Philip B. Krause | Internal Medicine | 9650 Gross Point Rd Ste 4900, Skokie, IL 60076-1214 | 2006-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902456999 | Gateway Foundation, Inc | Clinic/Center | 4028 W. Dempster, Ste 100, Skokie, IL 60076 | 2019-09-12 |
| 1336798255 | Renee Rosenberg | Speech-Language Pathologist | C/o East Prairie School, 7616 N. East Prairie Road, Skoke, IL 60076 | 2019-09-04 |
| 1710531223 | Dw Care Solutions | Hospice Care, Community Based | 4556 Oakton St, Suite 205, Skokie, IL 60076 | 2019-08-01 |
| 1689228157 | Elaine Ng | Pharmacist | 9650 Gross Point Rd Suite 4900, Skokie, IL 60076 | 2019-08-01 |
| 1881169381 | Kathleen Pyles | Registered Nurse | 9650 Gross Point Rd # 4900, Skokie, IL 60076 | 2018-10-10 |
| 1174013452 | Vitae Health of Illinois LLC | Social Worker | 3450 Oakton St, Skokie, IL 60076 | 2018-05-13 |
| 1396253530 | Jodi Novick Okner | Social Worker | 9134 Kilbourn Avenue, Skokie, IL 60076 | 2018-01-22 |
| 1700335924 | Olumide Adeyemo | Nurse Practitioner | 4711 Golf Rd Suite 1250, Skokie, IL 60076 | 2016-09-28 |
| 1255705315 | Malka Rokach | Pharmacist | 3358 W Touhy, Skokie, IL 60076 | 2015-11-30 |
| 1578932620 | Katrina Margaret Keithley | Physician Assistant | 9669 Kenton Ave Ste 203, Skokie, IL 60076 | 2015-09-18 |
| Find all providers in zip 60076 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346563921 | Sushil K Sharma Md Sc | Internal Medicine | 9701 Knox Ave Ste 103, Skokie, IL 60076-1256 | 2010-03-10 |
| 1336235563 | David Maximilian Najman | Internal Medicine | 9650 Gross Point Rd., Suite 4900, Skokie, IL 60076-1214 | 2006-10-05 |
| 1568759272 | Mohd Arman Qamar | Internal Medicine | 9650 Gross Point Rd Ste 4900, Skokie, IL 60076-5080 | 2011-07-01 |
| 1841502028 | Kambiz Zorriasateyn | Internal Medicine | 9650 Gross Point Rd Ste 4900, Skokie, IL 60076-1214 | 2010-07-05 |
| 1669629887 | David Benjamin Marmor | Internal Medicine | 9977 Woods Dr Ste 300, Skokie, IL 60077-1057 | 2008-08-19 |
| 1598886368 | Alfonso Javier Tafur | Internal Medicine | 9650 Gross Point Rd Ste 4900, Skokie, IL 60076 | 2007-04-02 |
| 1285778472 | Abed E. Dehnee | Internal Medicine | 9650 Gross Point Rd Ste 4900, Skokie, IL 60076-5080 | 2007-02-19 |
| 1255471140 | Boruch Zucker | Internal Medicine | 9650 Gross Point Rd Ste 4900, Skokie, IL 60076 | 2007-02-08 |
| 1154476695 | Sushil K Sharma | Internal Medicine | 9669 Kenton Ave, Skokie, IL 60076-1266 | 2007-01-24 |
| 1083789127 | Edward B.j. Winslow | Internal Medicine | 9977 Woods Dr, 3rd Floor, Skokie, IL 60077-1057 | 2006-11-22 |
| Find all providers in SKOKIE | ||||
Please comment or provide details below to improve the information on BRUCE A. BERGELSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.