Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 209018909 | IL |
NPI | 1750849675 |
---|---|
Provider Name | Karlo Vincent Buenconsejo Benig |
First Address | Oak Lawn, IL 60453-2654 |
Second Address | Oak Lawn, IL 60453-2654 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2019 |
Last Update Date | 10/03/2019 |