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1831629401
ETHAN PATRICK BERG
SPRINGFIELD, IL
NPI
1831629401
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IL 125071205)
Enumeration Date
2017-06-15
Last Update Date
2017-06-15
Business Address
Dr. ETHAN PATRICK BERG DO
520 N 4TH ST
SPRINGFIELD, IL 62702-5238
Phone number: 217-545-8000
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Mailing Address
Dr. ETHAN PATRICK BERG DO
PO BOX 19670
SPRINGFIELD, IL 62794-9670
Phone number:
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