Provider Demographics
NPI:1750428967
Name:BERMAN, VALENTIN (MDPC)
Entity type:Individual
Prefix:MR
First Name:VALENTIN
Middle Name:
Last Name:BERMAN
Suffix:
Gender:M
Credentials:MDPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3711 N PINE GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-4121
Mailing Address - Country:US
Mailing Address - Phone:773-914-0753
Mailing Address - Fax:
Practice Address - Street 1:3711 PINE GROVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613
Practice Address - Country:US
Practice Address - Phone:773-914-0753
Practice Address - Fax:708-499-3515
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360811902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL31604167OtherBLUE CROSS BLUE SHIELD ID
IL036081190Medicaid
ILE60941Medicare UPIN