Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Dr. Beth M Marshall-Bergman , DO

Internal Medicine โ€ข Chicago, IL

Active NPI 1962791657 Individual Practitioner Female Practitioner Telehealth (some services)
Practice location in NPPES

125 S Wacker Dr Ste 300
Chicago, IL 606064421

Call 6175051520 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

125 S Wacker Dr Ste 300

Chicago, IL 606064421

Telephone 6175051520
Fax 6179288401
Organization at the Same NPPES Address or Phone
Sutter Chiropractic And Wellness Facility NPI 1245561794

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Form Health Associates Ma, P.C.. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2011

Medicare patients

26 people with Original Medicare in 2024

Different Original Medicare patients in 2024; counts below 11 are hidden; this does not show availability or quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider, 2024.

Medicare-allowed amount

About $19,975 in 2024

The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.

What this does not show: Medicare-allowed amount

This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

Paid by Medicare

About $15,284 in 2024

The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.

What this does not show: Paid by Medicare

This is not the clinician's income and not a measure of quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

30-day fills

155 standardized 30-day fills in 2024

CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.

What this does not show: 30-day fills

It is not a count of patients and not a measure of quality.

Part D drug cost

$55,774 in 2024

The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.

What this does not show: Part D drug cost

A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.

Source: CMS, Medicare Part D Prescribers โ€“ by Provider and Drug, 2024.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019โ€“2025.

Guide: How to read an Open Payments record

Years since graduation

15 years (graduated 2011)

CMS Doctors and Clinicians data list 2011 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2011

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

May accept Medicare assignment

CMS data show this clinician may accept Medicare assignment. Clinicians who do not always accept assignment can decide case by case.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, โ€œDoes your provider accept Medicare as full payment?โ€

Guide: What Medicare assignment means

Telehealth (some services)

Recent Medicare claims show this clinician provided some services by telehealth, such as a video or phone visit.

What this does not show: Telehealth (some services)

It does not mean all services are offered by telehealth, or that telehealth is covered by your plan.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Marshall-Bergman has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Marshall-Bergman as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Chicago and Illinois

Billing and prescribing volume is not a quality rating.

Medicare Part B services

Close to the middle for clinicians listed under Internal Medicine in Chicago, IL (2024, 1,008 clinicians with data). Median for this group: 406. Middle half: 157 to 820.

Fewer Medicare Part B services than 70% of clinicians listed under Internal Medicine in Illinois (2024, 3,249 clinicians with data). Median for this group: 699. Middle half: 285 to 1,340.

Medicare-allowed amount

A lower Medicare-allowed amount than 65% of clinicians listed under Internal Medicine in Chicago, IL (2024, 1,008 clinicians with data). Median for this group: $41,573. Middle half: $14,662 to $79,189.

A lower Medicare-allowed amount than 80% of clinicians listed under Internal Medicine in Illinois (2024, 3,249 clinicians with data). Median for this group: $67,802. Middle half: $27,619 to $124,679.

Paid by Medicare

A lower Medicare payment amount than 65% of clinicians listed under Internal Medicine in Chicago, IL (2024, 1,008 clinicians with data). Median for this group: $31,519. Middle half: $10,954 to $62,185.

A lower Medicare payment amount than 80% of clinicians listed under Internal Medicine in Illinois (2024, 3,249 clinicians with data). Median for this group: $52,838. Middle half: $21,117 to $98,214.

Medicare Part D prescriptions

Fewer Part D prescriptions than 70% of clinicians listed under Internal Medicine in Chicago, IL (2024, 1,269 clinicians with data). Median for this group: 474. Middle half: 74 to 2,358.

Fewer Part D prescriptions than 75% of clinicians listed under Internal Medicine in Illinois (2024, 3,755 clinicians with data). Median for this group: 1,030. Middle half: 99 to 4,658.

Part D drug cost

Close to the middle for clinicians listed under Internal Medicine in Chicago, IL (2024, 1,269 clinicians with data). Median for this group: $40,678. Middle half: $1,543 to $232,098.

Close to the middle for clinicians listed under Internal Medicine in Illinois (2024, 3,755 clinicians with data). Median for this group: $78,716. Middle half: $2,604 to $371,507.

2,870 active clinicians are listed under Internal Medicine with a practice address in Chicago, IL (7,245 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Chicago

13.3% of these 2,870 clinicians have the CMS telehealth indicator.

38.5% of these 2,870 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2024), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo ยท Report an error.

Performed Procedures & Service Volume

Services billed to Original Medicare Part B in 2024.

CMS Part B ยท Data Year 2024
Reporting Year:

CPTยฎ is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2016โ€“2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners โ€“ by Provider and Service data, 2017โ€“2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

HCPCS Code Services Patients Submitted Charge Medicare Allowed
99454 Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days
83 16 $120.00 $45.39
99457 Management using the results of remote vital sign monitoring per calendar month, first 20 minutes
81 18 $110.00 $47.61
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
80 23 $285.00 $125.61
99458 Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes
60 14 $88.00 $38.38

Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits

Submitted charges are billed amounts, not a price quote for your visit.

Medicare Part D Prescribing Profile & Medications

Medicare Part D prescriptions filled, including refills, in 2024.

CMS Part D ยท Data Year 2024
Prescription Year:
Brand Name Generic Name Prescriptions Day Supply Total Cost Patients
Metformin Hcl Er Metformin Hcl 23 1,232 $213.23 โ€”
Naltrexone Hcl Naltrexone Hcl 20 840 $696.09 โ€”
Bupropion Xl Bupropion Hcl 16 960 $148.47 โ€”
Ozempic Semaglutide 15 742 $23,746.95 โ€”
Mounjaro Tirzepatide 12 448 $16,426.67 โ€”
Wegovy Semaglutide 11 308 $14,542.80 โ€”

Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-06-24
Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

License # reported to NPPES IL 036.135673

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

License # reported to NPPES TN 4856

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

License # reported to NPPES WV 3894

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

License # reported to NPPES KY C0750

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

License # reported to NPPES AL 2877

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

License # reported to NPPES MI EMC0001956

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

License # reported to NPPES MS 30199

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

License # reported to NPPES GA 91988

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - INTERNAL MEDICINE

Medicare Enrollment ID

I20141027000934

Enrollment State Jurisdiction

IL

PECOS Control ID

0840411328

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Form Health Associates Ma, P.c.

None, Chicago, IL 60606

Phone: 6175051520

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

40 listed
Olalekan Adefowokan , FNP

Nurse Practitioner - Family

NPI 1295128791

Family Nurse Practitioner

Dr. Robert Ander , MD

Family Medicine

NPI 1588051122

Doctor of Medicine (M.D.)

Shelley Anderson , NP

Nurse Practitioner - Family

NPI 1457812299

Nurse Practitioner

Nicole Arrieta , PA-C

Physician Assistant

NPI 1821717893

Physician Assistant (Certified)

Dr. Lisa Bellanfonte , MD

Internal Medicine

NPI 1275625113

Doctor of Medicine (M.D.)

Heidi Bohlmann , APRN, FNP-BC

Nurse Practitioner - Family

NPI 1457388464

Advanced Practice Registered Nurse, Family Nurse Practitioner (Board Certified)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
๐Ÿ“
Updated Practice Location June 24, 2026

Registered at 125 S WACKER DR STE 300, CHICAGO, IL 606064421 (Tel: 6175051520)

๐Ÿ“
Updated Business Mailing Address June 24, 2026

Registered at 109 STATE ST STE 5, BOSTON, MA 021092906 (Tel: 6175051520)

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 24, 2026

Internal Medicine (license number reported to NPPES: TN 4856)

โœ…
NPI Profile Active March 23, 2015

NPI status registered as active in NPPES database

๐Ÿ“
Practice Location (Initial Record) March 23, 2015

Registered at 610 S MAPLE AVE, SUITE 4600, OAK PARK, IL 603041091 (Tel: 7086602240)

๐Ÿ“
Business Mailing Address (Initial Record) March 23, 2015

Registered at 610 S MAPLE AVE, SUITE 4600, OAK PARK, IL 603041091

๐Ÿ‘ค
Provider Name / Credentials (Initial Record) March 23, 2015

Recorded as BETH MARSHALL-BERGMAN, D.O.

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 23, 2015

Internal Medicine (license number reported to NPPES: IL 036.135673)

๐ŸŸข
Initial NPI Registration & Enumeration April 04, 2011

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1962791657
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 04, 2011
Last Update: June 24, 2026
Sole Proprietor: No

Other Internal Medicine Providers in Chicago

All Internal Medicine Providers in Chicago

Mailing Address

109 State St Ste 5

Boston, MA 021092906

Phone: 6175051520

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.