John William Benge, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036053646 Issued in IL

Practice address

800 N Westmoreland Rd
Suite 102
Lake Forest, IL 60045-1673

Phone

(847) 735-8550

Fax

(847) 582-2198

NPI assigned

Sep 9, 2005

Last updated

Jul 17, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• J William Benge Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Heart Specialists

  dba Drs. Jajeh & Koch SC

  • Cardiovascular Disease Physician
  • Gurnee, IL
  • NPI 1629063391
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1285628859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD",
            "address_2": "SUITE 102",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451673",
            "telephone_number": "847-735-8550",
            "fax_number": "847-582-2198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD",
            "address_2": "SUITE 102",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451673",
            "telephone_number": "847-735-8550",
            "fax_number": "847-582-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENGE",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036053646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MPIN",
            "identifier": "1699507",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036053646",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4468170",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J",
            "last_name": "BENGE",
            "middle_name": "WILLIAM",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mugurel Valentin Bazavan, MD
• Lisa L Bednar, APRN
• Paul Matthew Been, D.O.
• Deborah Ann Belcore, RD, LDN
• Michael Belmont
• Adam W. Bennett, MD
• Ann Benny Stephen, AUD
• Deborah L Berg, CCC-SLP
• Joyce Ellen Berger
• Mimi Claire Bergman, DPT

• Cardiovascular Disease Physician in Lake Forest, IL
• Providers in Lake Forest, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.