Individual
DR. TARA Z. BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
900 N. 1ST STREET, SPRINGFIELD, IL 62702-3749
(217) 528-7541
(217) 525-1007
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036087658
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036087658
—
IL
Enumeration date
10/13/2005
Last updated
05/20/2020
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