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Individual

BENJAMIN WILLIAM PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-6880
Mailing address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-5101

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-118301
IL
208000000X
Pediatrics Physician
036118301
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036118301
IL
Enumeration date
02/20/2007
Last updated
04/12/2021
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