Individual
DR. LISA ANN BENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
701 N 1ST ST, SPRINGFIELD, IL 62702-3757
(217) 528-7541
(217) 753-0815
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
(217) 528-8962
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036078400
IL
208M00000X
Hospitalist Physician
036078400
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036078400
—
IL
Enumeration date
07/08/2005
Last updated
09/25/2013
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