Provider Demographics
NPI:1609982198
Name:SARMIENTO, BERNADETTE M (PT)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:M
Last Name:SARMIENTO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3827 WHITE CLOUD DR
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1727
Mailing Address - Country:US
Mailing Address - Phone:847-401-4607
Mailing Address - Fax:847-983-4296
Practice Address - Street 1:3827 WHITE CLOUD DR
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1727
Practice Address - Country:US
Practice Address - Phone:847-401-4607
Practice Address - Fax:847-983-4296
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics