Basic Information
Provider Information
NPI: 1194791459
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BERNSTEIN
FirstName: MATTHEW
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 929 W HIGGINS RD
Address2:  
City: SCHAUMBURG
State: IL
PostalCode: 601953203
CountryCode: US
TelephoneNumber: 8472854200
FaxNumber: 8478850130
Practice Location
Address1: 929 W HIGGINS RD
Address2:  
City: SCHAUMBURG
State: IL
PostalCode: 601953203
CountryCode: US
TelephoneNumber: 8472854200
FaxNumber: 8478850130
Other Information
ProviderEnumerationDate: 02/27/2006
LastUpdateDate: 07/06/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/06/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X036104463ILN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XS0106X036-104463ILY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery

ID Information
IDTypeStateIssuerDescription
036-10446305IL MEDICAID
20004518601ILMEDICARE RAILROADOTHER


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