Provider Demographics
NPI:1891977450
Name:ANTONIO F. BERNAS MDSC
Entity Type:Organization
Organization Name:ANTONIO F. BERNAS MDSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:309-794-0800
Mailing Address - Street 1:2508 25TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-5419
Mailing Address - Country:US
Mailing Address - Phone:309-794-0800
Mailing Address - Fax:
Practice Address - Street 1:2508 25TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-5419
Practice Address - Country:US
Practice Address - Phone:309-794-0800
Practice Address - Fax:309-794-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL213620Medicare PIN