Bernadette Mary Grogan, RD | |
2800 W 95th St, Evergreen Park, IL 60805-2701 | |
(708) 422-6200 | |
Not Available |
Full Name | Bernadette Mary Grogan |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 2800 W 95th St, Evergreen Park, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1891917019 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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133V00000X | Dietitian, Registered | (Illinois) | Primary |
Provider Name | Osf Multi-specialty Group |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
Mailing Address | Practice Location Address |
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Bernadette Mary Grogan, RD 6219 W 128th Pl, Palos Heights, IL 60463-2325 Ph: (708) 388-5912 | Bernadette Mary Grogan, RD 2800 W 95th St, Evergreen Park, IL 60805-2701 Ph: (708) 422-6200 |
Allison Margaret Wildman, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2800 W 95th St, Evergreen Park, IL 60805 Phone: 708-229-5923 | |
Patricia A Yerkes, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2800 W 95th St, Evergreen Park, IL 60805 Phone: 708-422-6200 | |
Aileen Marie Dukelow, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2800 W 95th St, Evergreen Park, IL 60805 Phone: 708-229-5906 | |
Ms. Louann Marie Sopata, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2800 W 95th St, Evergreen Park, IL 60805 Phone: 708-422-6200 | |
Robin Diaz-grady, RD, CSR, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3650 W 95th St, Evergreen Park, IL 60805 Phone: 708-422-7715 Fax: 708-422-7816 | |
Michelle A Potempa, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2800 W 95th St, Evergreen Park, IL 60805 Phone: 708-422-6200 | |
Lisa Marie Micetich, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2800 W 95th St, Evergreen Park, IL 60805 Phone: 708-229-5429 Fax: 708-229-5308 |