Individual
CHELSEA BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
950 S MULFORD RD, ROCKFORD, IL 61108-4274
(815) 209-5449
Mailing address
11267 VALERIAN WAY, ROSCOE, IL 61073-6401
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004064
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160004064
PTA LICENSE
IL
Enumeration date
03/19/2007
Last updated
06/27/2019
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