Provider Demographics
NPI:1043443005
Name:BERNABE, CONCEPCION E (MD)
Entity Type:Individual
Prefix:DR
First Name:CONCEPCION
Middle Name:E
Last Name:BERNABE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 E GOLF RD
Mailing Address - Street 2:SUITE 2133
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-5222
Mailing Address - Country:US
Mailing Address - Phone:847-290-9122
Mailing Address - Fax:
Practice Address - Street 1:855 E GOLF RD
Practice Address - Street 2:SUITE 2133
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-5222
Practice Address - Country:US
Practice Address - Phone:847-290-9122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036057756207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL001602293OtherIDPFR PIN