Benavides, Angela
Benavides, Angela is an individual health care provider with primary practice located at 1400 Midtown Rd , Peru IL 61354-1269. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Benavides, Angela can be contacted via phone (815) 220-2693.Contact Information
Primary practice address
1400 Midtown Rd
Peru IL 61354-1269
Phone: (815) 220-2693
Fax: (815) 220-2640
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 036074277 | Illinois |
Profile Details
| NPI number | 1760478887 |
|---|---|
| LBN Legal business name | Benavides, Angela |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 23rd, 2005 |
| Last updated | Dec 12th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760478887 | NPPES |
| Illinois | MEDICAID | 036074277 |
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