# BENJAMIN SAMUEL MD S C

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639338254
- **Authorized official:** DR. BENJAMIN SAMUEL M.D. (PRESIDENT)
- **Authorized official phone:** (773) 220-3972

## Contact information

- **Practice address:** 2525 S MICHIGAN AVE MAIL BOX 216, CHICAGO, IL 60616-5475
- **Practice address phone:** (773) 220-3972
- **Mailing address:** 533 W BARRY AVE APT 16F, CHICAGO, IL 60657-5475
- **Mailing address phone:** (773) 220-3972

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | 036094563 | IL | Yes |

## Other

- **Enumeration date:** 06/09/2008
- **Last updated:** 07/21/2022