RALPH S BENEJAM (NPI# 1548363765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548363765 |
| Entity Type | Individual |
| Full Name | RALPH S BENEJAM |
| Credential | M.D. |
| Practice Address |
3315 N Seminary St Galesburg IL 61401-1251 |
| Practice Telephone | 3093441000 |
| Practice Fax Number | 3093441054 |
| Mailing Telephone | 3093441000 |
| Mailing Fax Number | 3093441054 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 36062477 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AETNA | 4319365 | 01 | |
| CAQH | 10573902 | 01 | |
| IL | JOHN DEERE | 364271985-03 | 01 |
| BC/BS | 4815127 | 01 |
| Street Address |
3315 N SEMINARY ST |
| City | GALESBURG |
| State | IL |
| Zip Code | 61401-1251 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487696126 | Noor A Khaiser | Internal Medicine | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2006-06-10 |
| 1669022752 | Angela M Bickett | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2019-09-19 |
| 1902455140 | Bailey Jean Bucher | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2019-09-10 |
| 1417509407 | Tara Lynn Livingston | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2019-07-10 |
| 1164984225 | Julie Anne Maner-stevenson | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2019-04-05 |
| 1629573878 | Brittany S Simmons | Physician Assistant | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2018-03-29 |
| 1508360066 | Angela B Klapp | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2018-03-20 |
| 1962831511 | Amanda Ryan | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2013-11-04 |
| 1922436682 | Jackie Spence | Physician Assistant | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2013-10-16 |
| 1003164617 | Melissa Hajostek | Nurse Practitioner | 3315 N Seminary St, Galesburg, IL 61401-1251 | 2012-08-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679174973 | Jeff Engwall | Pharmacist | 359 Knox Square Drive, Galesburg, IL 61401 | 2020-11-03 |
| 1861962441 | Becky Cameron | Counselor | 2323 Windish Dr., Galesburg, IL 61401 | 2018-11-27 |
| 1295245496 | Aaron Thomas Wachtel | Dentist | 1172 Monroe Street, Galesburg, IL 61401 | 2017-10-03 |
| 1588182224 | Alicia Warren | Speech-Language Pathologist | 932 Harrison St., Galesburg, IL 61401 | 2017-09-01 |
| 1770986770 | Virginia G Kasser | Psychologist | 575 N Kellogg, Galesburg, IL 61401 | 2014-10-03 |
| 1063814309 | Lakshmi Kalyani Gudavalli | Physical Therapist | 275 E Carl Sandburg Drive, Marigold Rehabilitation, Galesburg, IL 61401 | 2014-09-18 |
| 1821350489 | James Eugene Tiller | Psychologist | 2101 Windish Drive, Galesburg, IL 61401 | 2012-06-11 |
| 1720285836 | Donald J. Regnier | Hearing Instrument Specialist | 4l Plaza, Suite 57, Galesburg, IL 61401 | 2007-07-02 |
| 1306066535 | Arnold John Minor | Dentist | 69 N Chambers St, Galesburg, IL 61401 | 2007-04-30 |
| 1114140373 | Community Residential Centers Inc | Intermediate Care Facility, Mentally Retarded | 239 S Cherry Street, Galesburg, IL 61401 | 2007-04-10 |
| Find all providers in zip 61401 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568460970 | Thomas H Patterson | Urology | 834 N Seminary St, Suite 502, Galesburg, IL 61401-2852 | 2005-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699236612 | Behdod Katebian | Urology | 5841 S Maryland Ave Rm J-653, Chicago, IL 60637-1443 | 2019-03-31 |
| 1912436015 | Robert Ara Petrossian | Urology | 301 N 8th St # 4b143c, Springfield, IL 62701-1041 | 2017-06-12 |
| 1134657026 | Soojin Kim | Urology | 225 E. Chicago Avenue, Box 24, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611 | 2017-05-23 |
| 1619337912 | George Robert Buckun | Urology | 930 Rogers St., #301, Downers Grove, IL 60515 | 2016-02-29 |
| 1275991606 | Nicole Alyssa Hamilton | Urology | 22285 N Pepper Rd Ste 201, Lake Barrington, IL 60010-2540 | 2016-01-30 |
| 1790164002 | Shay Golan | Urology | 5841 S Maryland Ave Mc6038, Chicago, IL 60637-1447 | 2015-05-20 |
| 1528453594 | Christopher Stockdale | Urology | 300 W Hill St Apt 707, Chicago, IL 60610-7537 | 2015-04-06 |
| 1639568447 | Jeremy Lai | Urology | 420 E Superior St Ste 9-900, Chicago, IL 60611-4494 | 2015-01-16 |
| 1386053759 | Ramiro Felix Prudencio | Urology | 1200 Broadmeadow Rd, Winnetka, IL 60093-3707 | 2014-08-10 |
| 1174933048 | Kyle John Ericson | Urology | 924 E 57th St, Suite 104, Chicago, IL 60637-1455 | 2014-05-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.