National Provider Identifier Database

BERNARDITA R ENRIQUEZ, MD – NPI #1952395972
Pediatrics

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.


Contact Information

BERNARDITA R ENRIQUEZ, MD
2750 11TH ST
ROCK ISLAND, IL61201-5216
Phone: 563-327-2100
Fax: 563-327-2102
Website:
Specialty Taxonomy Code
* Pediatrics 208000000X
Pediatric Emergency Medicine 2080P0204X

* Indicates primary specialty

NPI Profile & details for BERNARDITA R ENRIQUEZ

NPI Number 1952395972
Credentials MD
Entity Individual
Enumeration date 09/06/2005
Last updated 03/07/2023 - About 3 years ago
Sole proprietor1 No
Identifiers
  • IA License #: 34871
  • IL License #: 036-066809
  • IA Medicaid: 0568980
  • IA Medicaid: 0568998
  • IL Medicaid: 036066809
  • IL Medicaid: 421060724005
  • Other: 093469 HEALTH ALLIANCE #
  • IA Other: 421060724 BILLING TAX ID# FOR CHC
  • IA Other: 93612 IOWA BC/BS SEEN IN RI
  • IL Other: 336031012 CONTROLLED SUBSTANCE #
  • IL Other: 8122859 ILLINOIS BC/BS
  • IL Other: IL01A5 JOHN DEERE EDI#
  • IL Other: 421606724A5 JOHN DEERE HEALTH
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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