Benjamin, Mark J

Benjamin, Mark J is an sole proprietor health care provider with primary practice located at 5201 Willow Springs Rd Suite 450, La Grange Highlands IL 60525-6537. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Benjamin, Mark J can be contacted via phone (708) 354-2008.

Contact Information

Primary practice address
5201 Willow Springs Rd Suite 450 La Grange Highlands IL 60525-6537
Fax: (708) 354-2092
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036095352 Illinois

Profile Details

NPI number 1366433138
LBN Legal business name Benjamin, Mark J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 2nd, 2005
Last updated Feb 25th, 2009 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366433138 NPPES
Illinois Other 1532015 BLUE CROSS BLUE SHIELD

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