Provider Demographics
NPI:1093939225
Name:BERNARDINO, ELIZABETH VALENCIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:VALENCIA
Last Name:BERNARDINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7055 VETERANS BLVD
Mailing Address - Street 2:UNIT C
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5634
Mailing Address - Country:US
Mailing Address - Phone:630-325-4899
Mailing Address - Fax:630-325-4811
Practice Address - Street 1:7055 VETERANS BLVD
Practice Address - Street 2:UNIT C
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-5634
Practice Address - Country:US
Practice Address - Phone:630-325-4899
Practice Address - Fax:630-325-4811
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL2084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine