Individual
BENJAMIN JASON WAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
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
Update your record
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