Provider Demographics
NPI:1093943409
Name:BERMAN, NORMA C (D C)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:C
Last Name:BERMAN
Suffix:
Gender:F
Credentials:D C
Other - Prefix:MISS
Other - First Name:NORMA
Other - Middle Name:C
Other - Last Name:MOQUIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 ROOSEVELT RD
Mailing Address - Street 2:BLDG. E, STE. 220
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5839
Mailing Address - Country:US
Mailing Address - Phone:630-469-1527
Mailing Address - Fax:630-469-1841
Practice Address - Street 1:800 ROOSEVELT RD
Practice Address - Street 2:BLDG. E, STE. 220
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5839
Practice Address - Country:US
Practice Address - Phone:630-469-1527
Practice Address - Fax:630-469-1841
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038006938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL2537001Medicare UPIN