KIRK BERGMARK (NPI# 1851346654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851346654 |
| Entity Type | Individual |
| Full Name | KIRK BERGMARK |
| Credential | A.P.R.N.,C.N.S. |
| Practice Address |
15300 West Ave Suite 313 Orland Park IL 60462-4600 |
| Mailing Address |
12251 S 80th Ave Ste 1630 Palos Heights IL 60463-1256 |
| Practice Telephone | 7089237878 |
| Practice Fax Number | 7089237888 |
| Mailing Telephone | 7089235173 |
| Mailing Fax Number | 7089235018 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2020-01-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
277.000284 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
277000284 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
15300 WEST AVE SUITE 313 |
| City | ORLAND PARK |
| State | IL |
| Zip Code | 60462-4600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902804628 | John G Hohner | Neuromusculoskeletal Medicine & OMM | 15300 West Ave, Orland Park, IL 60462-4600 | 2005-07-07 |
| 1508463969 | Brianna Panka | Social Worker | 15300 West Ave, Orland Park, IL 60462-4600 | 2020-10-07 |
| 1275157133 | Lauren Renee Zuro | Dietitian, Registered | 15300 West Ave, Orland Park, IL 60462-4600 | 2020-06-05 |
| 1942751664 | Michelle Marie Hartnett | Physician Assistant | 15300 West Ave, Suite 20 South, Orland Park, IL 60462-4600 | 2016-10-18 |
| 1003295338 | Andrea Jean Moormann | Occupational Therapist | 15300 West Ave, West Bldg., Suite 310, Orland Park, IL 60462-4600 | 2015-05-19 |
| 1073909123 | Eugenia Kyriakopoulos | Family Medicine | 15300 West Ave, Orland Park, IL 60462 | 2015-04-15 |
| 1962892232 | Mary A Merlo | Nurse Practitioner | 15300 West Ave, Orland Park, IL 60462-4600 | 2015-01-26 |
| 1063814796 | Oral & Maxillofacial Surgery of Chicago | Dentist | 15300 West Ave, Orland Park, IL 60462-4600 | 2014-09-25 |
| 1881008472 | Robin Lee Gallardi | Dentist | 15300 West Ave, Suite 113, Orland Park, IL 60462-4600 | 2014-06-11 |
| 1275954117 | Mary T Rhodes I | Nurse Practitioner | 15300 West Ave, Orland Park, IL 60462-4600 | 2013-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083257331 | Stephanie Slager | Behavioral Analyst | 8430 W 135th St., Orland Park, IL 60462 | 2019-10-18 |
| 1730652587 | Nancy Lynch | Speech-Language Pathologist | 15100 S 94th Ave Orland School District 135, Orlond Park, IL 60462 | 2019-01-04 |
| 1932681327 | Alyssa Avant | Speech-Language Pathologist | 8851 W 151st St, Orland Park, IL 60462 | 2018-08-31 |
| 1922588110 | Pain Specialists of Greater Chicago S C | Pain Medicine | 15300 West Ave Ste C213, Orland Park, IL 60462 | 2018-08-16 |
| 1689168478 | S- R&r Counseling Inc. | Counselor | 9750 Crescent Park Cir Unit 306, Orland Park, IL 60462 | 2018-06-15 |
| 1104372952 | Amy Blanks | Nurse Anesthetist, Certified Registered | 13959 95th Avenue, Orland Park, IL 60462 | 2016-08-31 |
| 1740632454 | Anna S Wang | Optometrist | 14494 John Humphrey Dr, Orland Park, IL 60462 | 2016-07-06 |
| 1750739793 | Carolyn Sluis | Pharmacist | 9352 W 159th Street, Orland Park, IL 60462 | 2016-06-01 |
| 1164882262 | Caring Hands Group Home of Il, Inc. | Community/Behavioral Health | 14475 John Humphrey Dr., Orland Park, IL 60462 | 2016-03-02 |
| 1639539760 | Frazierworks Community Care, Inc. | In Home Supportive Care | 14475 John Humphrey Dr Suite 300, Orland Park, IL 60462 | 2016-03-02 |
| Find all providers in zip 60462 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023187069 | Kay Budick | Nurse Practitioner | 14400 John Humphrey Dr, Suite 200, Orland Park, IL 60462-2897 | 2006-11-06 |
| 1902411093 | Becoming Behavioral Health & Wellness Pllc | Nurse Practitioner | 15255 S 94th Ave Ste 500, Orland Park, IL 60462-3895 | 2020-09-15 |
| 1659927044 | L&k Consulting | Nurse Practitioner | 11520 183rd Pl Ste 100, Orland Park, IL 60467-9476 | 2019-08-13 |
| 1013118413 | Benchmark Psychiatric Services, Ltd. | Nurse Practitioner | 11231 Distinctive Dr, Orland Park, IL 60467-9458 | 2007-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384451 | Ghea Tiping Degillo | Nurse Practitioner | 4711 Golf Rd Ste 500, Skokie, IL 60076-1208 | 2020-10-22 |
| 1750989620 | Rodney J Pena Jr. | Nurse Practitioner | 1362 Trotters Ln, Bourbonnais, IL 60914-4519 | 2020-10-13 |
| 1609482231 | Crystal Lynn Jordan | Nurse Practitioner | 638 Oakbrook Ave, Chatham, IL 62629 | 2020-09-18 |
| 1497369672 | Mojisola Abayemi Akinfe | Nurse Practitioner | 8572 Stone Creek Blvd, Frankfort, IL 60423-9338 | 2020-09-03 |
| 1508475039 | Hilary Eichie | Nurse Practitioner | 20025 Division St., Crest Hill, IL 60403 | 2020-07-30 |
| 1518585942 | Tabs Behavioral Health Inc | Nurse Practitioner | 13316 Vicarage Dr, Plainfield, IL 60585-5050 | 2020-07-13 |
| 1154946788 | Latisha Trenice Stennis | Nurse Practitioner | 8106 Carol Dr, East Saint Louis, IL 62203-1838 | 2020-06-09 |
| 1114549755 | Maria Andreea Bordeianu | Nurse Practitioner | 6050 N California Ave, Chicago, IL 60659-3916 | 2020-05-16 |
| 1104448968 | Abosede Rachel Babalola | Nurse Practitioner | 2214 Monarch St, Bourbonnais, IL 60914-2780 | 2020-05-14 |
| 1659909406 | Mudira Temilola Oyewole | Nurse Practitioner | 493 Leslie Ct, Des Plaines, IL 60016-8818 | 2020-03-28 |
| Find all providers with the same taxonomy | ||||
| City | ORLAND PARK |
| Zip Code | 60462 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.