Provider Demographics
NPI:1407296171
Name:BERNSTEIN, JENNIFER E (DPM)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:E
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1660 FEEHANVILLE DR STE 450
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-6023
Mailing Address - Country:US
Mailing Address - Phone:847-250-9096
Mailing Address - Fax:847-390-9345
Practice Address - Street 1:1900 HOLLISTER DR STE 160
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5227
Practice Address - Country:US
Practice Address - Phone:847-250-9096
Practice Address - Fax:847-390-9345
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI107725213EP1101X
IL016005699213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine