Individual
BENJAMIN JASON WAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
3936 N MILWAUKEE AVE, CHICAGO, IL 60641-2703
(630) 368-1771
(708) 658-2750
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 890-5900
(847) 390-4757
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070014503
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00684771
MEDICARE RR
IL
01
—
P00776867
MEDICARE RR
IL
01
—
P00943153
MEDICARE RAILROAD
IL
Enumeration date
02/13/2008
Last updated
07/14/2023
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