Dr. Marisenda Benitez
Foot Surgery
2504 Washington St Suite 505
Waukegan
, Illinois 60085-3505
Dr. Marisenda Benitez
Foot Surgery
2504 Washington St Suite 505
Waukegan
, Illinois 60085-3505
(847) 336-9937
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About
Features
Specialties
- Foot Surgery
Languages spoken
- English
Location
First Address
- Dr. Marisenda Benitez
- 2504 Washington St Suite 505
- Waukegan, IL
- Zip : 60085-3505
- Fax : (847) 336-9937
- Phone : (847) 336-9930
Second Address
- Dr. Marisenda Benitez
- 2504 Washington St Suite 505
- Waukegan, IL
- Zip : 60085-3505
- Fax : (847) 336-9937
- Phone : (847) 336-9930
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213ES0131X | Foot Surgery | 316-002339 | IL |
National Provider Identifier
| NPI | 1336115864 |
|---|---|
| Provider Name | Dr. Marisenda Benitez |
| First Address | Waukegan, IL 60085-3505 |
| Second Address | Waukegan, IL 60085-3505 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/02/2006 |
| Last Update Date | 08/06/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0001623503 | BLUE CROSS (01) | IL |
| 016005165 | (05) | IL |
| 5410292 | CIGNA (01) | IL |
| 6318020001 | DME (01) | IL |
| PTAN# POO414506 | RAILROAD GROUP CG8029 (01) | IL |
| U90775 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.