Provider Demographics
NPI:1558378406
Name:BERLIN, HOWARD HARVEY (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:HARVEY
Last Name:BERLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:721 ONTARIO ST
Mailing Address - Street 2:APT 207
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2100
Mailing Address - Country:US
Mailing Address - Phone:708-848-4553
Mailing Address - Fax:708-848-1702
Practice Address - Street 1:721 ONTARIO ST
Practice Address - Street 2:APT 207
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2100
Practice Address - Country:US
Practice Address - Phone:708-848-4553
Practice Address - Fax:708-848-1702
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL36-34700207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD11458Medicare UPIN
IL376830Medicare ID - Type Unspecified