| Benjamin Samuel Md S C | |
|
2525 S Michigan Ave Mail Box 216 Chicago IL 60616-5475 | |
| (773) 220-3972 | |
| Not Available |
| Full Name | Benjamin Samuel Md S C |
|---|---|
| Speciality | Internal Medicine |
| Location | 2525 S Michigan Ave Mail Box 216, Chicago, Illinois |
| Authorized Official Name and Position | Benjamin Samuel (PRESIDENT) |
| Authorized Official Contact | 7732203972 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin Samuel Md S C 533 W Barry Ave Apt 16f Chicago IL 60657-5475 Ph: (773) 220-3972 | Benjamin Samuel Md S C 2525 S Michigan Ave Mail Box 216 Chicago IL 60616-5475 Ph: (773) 220-3972 |
| NPI Number | 1639338254 |
|---|---|
| Provider Enumeration Date | 06/09/2008 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 1254404049 |
|---|---|
| Medicare Enrollment ID | O20080917000827 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639338254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 036094563 (Illinois) | Primary |
| Provider Name | Benjamin Udayakumar Samuel |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1649287947 PECOS PAC ID: 3072527209 Enrollment ID: I20060126000887 |
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