Provider Demographics
NPI:1215035977
Name:BERNTHAL, BETH C (AUD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:C
Last Name:BERNTHAL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 N COMMONS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-7940
Mailing Address - Country:US
Mailing Address - Phone:630-303-5380
Mailing Address - Fax:630-303-5385
Practice Address - Street 1:6991 MEDITERRANEAN DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75072-5536
Practice Address - Country:US
Practice Address - Phone:972-542-8900
Practice Address - Fax:972-542-8944
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90602237600000X
TX51002231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX036799702Medicaid
TX80366AOtherBLUE CROSS BLUE SHIELD
TXP00273212OtherRAILROAD MEDICARE
TXUS10698OtherBLUE CROSS BLUE SHIELD