Bennett, Jeffrey I

Bennett, Jeffrey I is an individual health care provider with primary practice located at 901 W Jefferson St , Springfield IL 62702-4833. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Bennett, Jeffrey I can be contacted via phone (217) 545-8229.

Contact Information

Primary practice address
901 W Jefferson St Springfield IL 62702-4833
Fax: (217) 545-2275
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 036-080065 Illinois

Profile Details

NPI number 1265410898
LBN Legal business name Bennett, Jeffrey I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2006
Last updated Oct 18th, 2020 - about 4 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 1265410898 NPPES
Illinois MEDICAID 036080065

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