Provider Demographics
NPI:1568543577
Name:HARVEY BERLIN MD SC
Entity Type:Organization
Organization Name:HARVEY BERLIN MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:W
Authorized Official - Last Name:BERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-346-5737
Mailing Address - Street 1:111 N WABASH AVE
Mailing Address - Street 2:1008
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1903
Mailing Address - Country:US
Mailing Address - Phone:312-346-5737
Mailing Address - Fax:312-346-8533
Practice Address - Street 1:111 N WABASH AVE
Practice Address - Street 2:1008
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1903
Practice Address - Country:US
Practice Address - Phone:312-346-5737
Practice Address - Fax:312-346-8533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-052948174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty