Provider Demographics
NPI:1134561616
Name:LERMAN, BELLA
Entity type:Individual
Prefix:
First Name:BELLA
Middle Name:
Last Name:LERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BELLA
Other - Middle Name:
Other - Last Name:SHARGORODSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 W CENTRAL RD STE 408
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2468
Mailing Address - Country:US
Mailing Address - Phone:847-392-0400
Mailing Address - Fax:847-394-8211
Practice Address - Street 1:1100 W CENTRAL RD STE 408
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2468
Practice Address - Country:US
Practice Address - Phone:847-392-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.149894207KA0200X, 207RA0201X, 207K00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036.149894OtherLICENSED PHYSICIAN AND SURGEON
FL7657414OtherDEA