Individual
MR. BENJAMIN SCOTT HULFACHOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
4143 N CENTRAL PARK AVE APT G, CHICAGO, IL 60618-2062
(815) 616-4559
Mailing address
4143 N CENTRAL PARK AVE APT G, CHICAGO, IL 60618-2062
(815) 616-4559
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
209021004
IL
Other
Enumeration date
07/28/2020
Last updated
07/28/2020
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