Provider Demographics
NPI:1245589993
Name:BERGIN, DAWN (APRN)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:
Last Name:BERGIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 OGDEN AVE.
Mailing Address - Street 2:SUITE 400
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-4386
Mailing Address - Country:US
Mailing Address - Phone:630-236-4300
Mailing Address - Fax:630-236-4302
Practice Address - Street 1:2020 OGDEN AVE.
Practice Address - Street 2:SUITE 400
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-4386
Practice Address - Country:US
Practice Address - Phone:630-236-4300
Practice Address - Fax:630-236-4302
Is Sole Proprietor?:No
Enumeration Date:2012-09-09
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.010521363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care