Individual
BENJAMIN JIAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 702-9662
(773) 702-1161
Mailing address
180 HARVESTER DR STE 110, BURR RIDGE, IL 60527-6686
(847) 312-9658
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036.175479
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2021
Last updated
04/28/2026
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