MRS. DESSA BENTON (NPI# 1992968143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992968143 |
Entity Type | Individual |
Full Name | MRS. DESSA BENTON |
Practice Address |
5500 S Damen Ave Chicago IL 60636-1107 |
Practice Telephone | 7737768800 |
Practice Fax Number | 7737768801 |
Mailing Telephone | 7737768800 |
Mailing Fax Number | 7737768801 |
Enumeration Date | 2008-07-08 |
Last Update Date | 2008-07-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
209000672 | IL | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LC1500X |
Nurse Practitioner Specialization: Community Health |
209-000672 | IL | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
209-000672 | IL | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
209-000672 | IL | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
5500 S DAMEN AVE |
City | CHICAGO |
State | IL |
Zip Code | 60636-1107 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962664268 | Jil Medical Consultant | Clinic/Center | 5500 S Damen Ave, Chicago, IL 60636-1107 | 2008-06-27 |
1649773144 | Dentum Dental Ltd | Dentist | 5500 S Damen Ave, Chicago, IL 60636-1107 | 2018-03-12 |
1346796000 | Tade O Akere | Psychologist | 5500 S Damen Ave, Chicago, IL 60636-1107 | 2016-08-31 |
1447542774 | Dhcc.,ltd | Dentist | 5500 S Damen Ave, Chicago, IL 60636-1107 | 2011-05-04 |
1952564551 | Vernon Michael Smith | Nurse Practitioner | 5500 S Damen Ave, Chicago, IL 60636-1107 | 2008-07-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124438742 | Habilitative Systems, Inc. | Case Management | 6845 S Western Ave, Chicago, IL 60636 | 2014-05-05 |
1346505286 | Sneha Abichandani | Pediatrics | 5843 South Western, Chicago, IL 60636 | 2012-07-06 |
1972812501 | Westwood Medical Ceter Inc | Surgery | 6326 S. Ashland Avenue, Chicago, IL 60636 | 2010-09-30 |
1104134915 | Mamanatandathernizampc. | Clinic/Center | 2001 W.69thst., Chicago, IL 60636 | 2010-09-15 |
1295966562 | Carla Maria Lennan | Durable Medical Equipment & Medical Supplies | 6343 S. Western, Chicago, IL 60636 | 2009-08-04 |
1083826507 | Devere J Herron | Dentist | 7203 South Western Avenue, Chicago, IL 60636 | 2007-05-04 |
1427155910 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 1620 West 59th St, Chicago, IL 60636 | 2006-09-19 |
1023031473 | J &j Pharmacy Ltd. | Pharmacist | 2001 W 69th Street, Clinic Pharmacy, Chicago, IL 60636 | 2006-07-26 |
1831169218 | Michael A. Luckett, Dmd & Associates (western | Dentist | 6153 South Western Avenue, Chicago, IL 60636 | 2006-01-26 |
1457330870 | Friend Family Health Center, Inc | Clinic/Center | 5843 S. Western Avenue, Chicago, IL 60636 | 2006-01-13 |
Find all providers in zip 60636 |
Taxonomy Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669937231 | Colleen Ann Larkin | Nurse Practitioner | 10939 S Troy St, Chicago, IL 60655-2211 | 2019-02-07 |
1487160586 | Meghan Doepke Sullivan | Nurse Practitioner | 1030 N Clark St Ste 400, Chicago, IL 60610-5468 | 2017-12-27 |
1366955940 | Debra Chana Goldstein | Nurse Practitioner | 2732 W Chase Ave, Chicago, IL 60645-1313 | 2017-11-06 |
1588189260 | Larissa Marie Schulze | Nurse Practitioner | 737 N Michigan Ave Ste 820, Chicago, IL 60611-6659 | 2017-08-03 |
1164887295 | Meredith Murphy Mcintee | Nurse Practitioner | 5841 S Maryland Ave # Mc4065, Chicago, IL 60637-1443 | 2015-12-16 |
1215345442 | Tara Seider | Nurse Practitioner | 2707 W Ainslie St, Unit #3, Chicago, IL 60625-2715 | 2014-07-31 |
1447697982 | Emily Thurn | Nurse Practitioner | 225 E Chicago Ave Box 29, Chicago, IL 60611-2605 | 2013-05-23 |
1518231505 | Julianne Deschler Bertalmio | Nurse Practitioner | 1460 N. Halsted Street, Suite 402, Chicago, IL 60642 | 2012-03-08 |
1932478765 | Julie Elizabeth Martin | Nurse Practitioner | 225 E Chicago, 4 Ne, Chicago, IL 60611-2605 | 2011-12-22 |
1245532480 | Alexandra Wilson Benz | Nurse Practitioner | 225 E Chicago Ave # 93, Chicago, IL 60611-2991 | 2010-11-20 |
Find all providers in CHICAGO |
Please comment or provide details below to improve the information on MRS. DESSA BENTON.
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.