Provider Demographics
NPI:1730643099
Name:BERGEN, FRANCESCA G
Entity Type:Individual
Prefix:MRS
First Name:FRANCESCA
Middle Name:G
Last Name:BERGEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 WILDBERRY LN
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-2943
Mailing Address - Country:US
Mailing Address - Phone:630-291-3012
Mailing Address - Fax:
Practice Address - Street 1:308 WILDBERRY LN
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-2943
Practice Address - Country:US
Practice Address - Phone:630-291-3012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst