| Brainerd Medical Center Sc | |
|
1222 W 95th St Chicago IL 60643-1408 | |
| (773) 445-8155 | |
| (773) 779-7186 |
| Full Name | Brainerd Medical Center Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1222 W 95th St, Chicago, Illinois |
| Authorized Official Name and Position | Vincent Rafer Benig (PRESIDENT) |
| Authorized Official Contact | 7734458155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brainerd Medical Center Sc 1222 W 95th St Chicago IL 60643-1408 Ph: (773) 445-8155 | Brainerd Medical Center Sc 1222 W 95th St Chicago IL 60643-1408 Ph: (773) 445-8155 |
| NPI Number | 1851435986 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851435986 | NPI | - | NPPES |
| 0001635931 | Other | IL | BCBS GROUP # |
| N276702 | Other | IL | CORAZON BENIG'S HARMONY# |
| P00299437 | Other | IL | CORAZON BENIG'S RRM PIN |
| P00288775 | Other | IL | VINCENT BENIG-RRM PIN |
| DE3749 | Other | IL | RAILROAD MEDICARE GRP# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
| 207R00000X | Internal Medicine | (Illinois) | Primary |
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