Individual
DR. ALAN D. BETENSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
676 N SAINT CLAIR ST STE 14-044, CHICAGO, IL 60611
(312) 908-8163
(312) 695-1394
Mailing address
25 N WINFIELD RD STE 204, WINFIELD, IL 60190-1379
(630) 232-0202
(630) 690-2293
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036157068
IL
207RP1001X
Pulmonary Disease Physician
Primary
036157068
IL
207RP1001X
Pulmonary Disease Physician
75987
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290H264420
BLUE CROSS-BLUE CROSS
—
05
—
442971510
—
MI
01
—
AB079325
CHAMPUS-CHAMPUS
—
Enumeration date
12/06/2006
Last updated
12/17/2024
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