Provider Demographics
NPI:1881625481
Name:BINDER, BERNARD A (MD)
Entity type:Individual
Prefix:
First Name:BERNARD
Middle Name:A
Last Name:BINDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2932 RESERVE CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-1344
Mailing Address - Country:US
Mailing Address - Phone:630-978-0124
Mailing Address - Fax:
Practice Address - Street 1:2932 RESERVE CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-1344
Practice Address - Country:US
Practice Address - Phone:630-978-0124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
L05317OtherINDIVIDUAL MEDICARE #
L05317OtherINDIVIDUAL MEDICARE #
ILL53664Medicare ID - Type Unspecified
A94009Medicare UPIN