Individual
MATTHEW BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
1530 S SHIELDS DR, WAUKEGAN, IL 60085-8307
(847) 731-5736
Mailing address
1530 S SHIELDS DR, WAUKEGAN, IL 60085-8307
(847) 731-5736
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-59463
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-22-59463
BEHAVIOR ANALYST CERTIFICATION BOARD
—
Enumeration date
06/18/2019
Last updated
07/12/2022
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