NPI 1992217129

Jason Bergmann, CPED

Practitioner Pedorthist Glenview, IL

Practice location

Address: 1864 Johns Dr, Glenview, IL 60025-1657
Phone: (847) 729-7923

Registered specialties

Pedorthist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224L00000X Licence 212.000209 (IL)

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Registry record

NPI: 1992217129
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Oct 2017
Record last updated: 27 Oct 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.