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
Phone: (708) 354-2008
Fax: (708) 354-2092
Website:
Health care specialties
| Specialty | Code | License # | 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 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366433138 | NPPES |
| Illinois | Other | 1532015 | BLUE CROSS BLUE SHIELD |
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