Individual
DR. ELLEN C BENYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
225 E CHICAGO AVE # 9, CHICAGO, IL 60611-2991
(312) 227-4500
(312) 227-9785
Mailing address
225 E CHICAGO AVE # 9, CHICAGO, IL 60611-2991
(312) 227-4500
(312) 227-9785
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
036078263
IL
2085R0202X
Diagnostic Radiology Physician
Primary
036.078263
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021622158
CMMG BLUE SHIELD
IL
05
—
036078263
—
IL
Enumeration date
07/29/2005
Last updated
11/15/2019
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