Individual
JOHN WILLIAM BENGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 N WESTMORELAND RD, SUITE 102, LAKE FOREST, IL 60045-1673
(847) 735-8550
(847) 582-2198
Mailing address
800 N WESTMORELAND RD, SUITE 102, LAKE FOREST, IL 60045-1673
(847) 735-8550
(847) 582-2198
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036053646
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036053646
—
IL
01
—
1699507
MPIN
IL
01
—
4468170
AETNA
IL
Enumeration date
09/09/2005
Last updated
07/17/2012
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