Individual
STEFANIE DUDA BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036104372
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036104372-4
—
IL
01
—
168211001
AR MEDICAID
AR
01
—
P00635664
TRAVELERS RR MEDICARE
—
Enumeration date
02/23/2006
Last updated
05/07/2021
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