Enriquez, Bernardita R

Enriquez, Bernardita R is an individual health care provider with primary practice located at 2750 11Th St , Rock Island IL 61201-5216. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Enriquez, Bernardita R can be contacted via phone (563) 327-2100.

Contact Information

Primary practice address
2750 11Th St Rock Island IL 61201-5216
Phone: (563) 327-2100
Fax: (563) 327-2102
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036-066809 Illinois
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 34871 Iowa
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 036-066809 Illinois

Profile Details

NPI number 1952395972
LBN Legal business name Enriquez, Bernardita R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2005
Last updated Mar 7th, 2023 - about 3 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 1952395972 NPPES
Iowa Other 421060724 BILLING TAX ID# FOR CHC
Iowa MEDICAID 0568980 BILLING TAX ID# FOR CHC
Iowa Other 421606724A5 BILLING TAX ID# FOR CHC
Iowa MEDICAID 0568998 BILLING TAX ID# FOR CHC
Iowa MEDICAID 421060724005 BILLING TAX ID# FOR CHC
Iowa MEDICAID 036066809 BILLING TAX ID# FOR CHC
Iowa Other 8122859 BILLING TAX ID# FOR CHC
Iowa Other 93612 BILLING TAX ID# FOR CHC
Iowa Other 093469 BILLING TAX ID# FOR CHC
Iowa Other 336031012 BILLING TAX ID# FOR CHC
Iowa Other IL01A5 BILLING TAX ID# FOR CHC

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