Bethany Burge M.D.

NPI 1205135944 - Urology - 208800000X

NPI Details
NPI 1205135944
Gender Female
Enumeration Date 03/21/2011
Last Updated 02/02/2015
Entity Type Individual
Active Over 5 years ago
Practice Location
2160 S. 1ST AVE.
BUILDING 54, ROOM 237A
MAYWOOD IL, 60153-3328, US
Phone (708) 216-5100
Fax (708) 216-6585
Business Location
2160 S. 1ST AVE.
BUILDING 54, ROOM 237A
MAYWOOD IL, 60153-3328, US
Phone (708) 216-5100
Fax (708) 216-6585
Toxanomy
Taxonomy Code 208800000X
License State Illinois
License Number 125060265
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According to our database, Bethany Burge M.D. NPI is 1205135944, taxonomy code is 208800000X and license number is 125060265, license state is located at Illinois. Bethany Burge M.D. physically located at 2160 S. 1st Ave., Maywood IL, 60153-3328. NPI Number Bethany Burge M.D. has the Individual type.

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1205135944 NPI number is provided on an as is basis without warranty of any kind. 1205135944 is maintained by the National Plan & Provider Enumeration System. The contents of Bethany Burge M.D. are for informational purposes only.