Organization
BENJAMIN SAMUEL MD S C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN SAMUEL M.D. (PRESIDENT)
(773) 220-3972
Entity
Organization
Contact information
Practice address
2525 S MICHIGAN AVE MAIL BOX 216, CHICAGO, IL 60616-5475
(773) 220-3972
Mailing address
533 W BARRY AVE APT 16F, CHICAGO, IL 60657-5475
(773) 220-3972
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
036094563
IL
Other
Enumeration date
06/09/2008
Last updated
07/21/2022
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