| David J. Benditzson, M.d., Ltd. | |
|
55 E Washington St Ste 2903 Chicago IL 60602-2268 | |
| (312) 266-1222 | |
| (312) 541-2810 |
| Full Name | David J. Benditzson, M.d., Ltd. |
|---|---|
| Speciality | Clinic/Center |
| Location | 55 E Washington St Ste 2903, Chicago, Illinois |
| Authorized Official Name and Position | David Jerome Benditzson (PRESIDENT) |
| Authorized Official Contact | 3122661222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David J. Benditzson, M.d., Ltd. 55 E Washington St Ste 2903 Chicago IL 60602-2268 Ph: (312) 266-1222 | David J. Benditzson, M.d., Ltd. 55 E Washington St Ste 2903 Chicago IL 60602-2268 Ph: (312) 266-1222 |
| NPI Number | 1760627137 |
|---|---|
| Provider Enumeration Date | 12/12/2008 |
| Last Update Date | 12/12/2008 |
| Medicare PECOS PAC ID | 2769545672 |
|---|---|
| Medicare Enrollment ID | O20090120000175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760627137 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 036040406 (Illinois) | Primary |
| Provider Name | David J Benditzson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518946656 PECOS PAC ID: 8325101231 Enrollment ID: I20090120000149 |
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