Individual
DR. BENEDICT IKEUDENTA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7702 N ALPINE RD, LOVES PARK, IL 61111-3107
(815) 971-3310
Mailing address
7561 CREEK BND, ROCKFORD, IL 61114-6663
(346) 322-5140
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
IL
Other
Enumeration date
03/23/2023
Last updated
03/23/2023
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