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Contact Information

MARK J BENJAMIN, MD
5201 WILLOW SPRINGS RD
SUITE 450
LA GRANGE HIGHLANDS, IL60525-6537
 Phone: 708-354-2008
 Fax: 708-354-2092
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for MARK J BENJAMIN · (Male)

NPI Number 1366433138
Status Active
Credentials MD
Entity Individual
Enumeration date 11/02/2005
Last updated 02/25/2009 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 036095352
  • IL Other 1532015 BLUE CROSS BLUE SHIELD
Hospital affiliation(s)
  • LORETTO HOSPITAL - (Acute Care)
    645 SOUTH CENTRAL AVE
    CHICAGO, IL 60644
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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