Phillips, Benjamin William

Phillips, Benjamin William is an individual health care provider with primary practice located at 180 S Main St , Canton IL 61520-2608. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Phillips, Benjamin William can be contacted via phone (309) 647-0201.

Contact Information

Primary practice address
180 S Main St Canton IL 61520-2608
Phone: (309) 647-0201
Fax: (309) 649-6880
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036118301 Illinois
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-118301 Illinois

Profile Details

NPI number 1275678021
LBN Legal business name Phillips, Benjamin William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2007
Last updated Apr 12th, 2021 - about 5 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 1275678021 NPPES
Illinois MEDICAID 036118301

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