Bertke, Michelle L

Bertke, Michelle L is an individual health care provider with primary practice located at 530 Ne Glen Oak Ave , Peoria IL 61637-0001. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bertke, Michelle L can be contacted via phone (309) 655-2312.

Contact Information

Primary practice address
530 Ne Glen Oak Ave Peoria IL 61637-0001
Phone: (309) 655-2312
Fax: (309) 655-4154
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X Illinois

Profile Details

NPI number 1710922182
LBN Legal business name Bertke, Michelle L
Credentials APN,CNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710922182 NPPES
Other 207414 MEDICARE GROUP NO.

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