Organization
PROPONENT MEDICAL GROUP,LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE F BERG M.D. (PRESIDENT)
(847) 697-3800
Entity
Organization
Contact information
Practice address
2350 ROYAL BLVD, SUITE 500, ELGIN, IL 60123-4719
(847) 697-3800
(847) 697-3804
Mailing address
2350 ROYAL BLVD, SUITE 500, ELGIN, IL 60123-4719
(847) 697-3800
(847) 697-3804
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
042617550
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4532006
BC/BS GROUP
IL
Enumeration date
10/17/2006
Last updated
12/28/2021
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