Organization
BRAINERD MEDICAL CENTER SC
Active
Organization
BRAINERD MEDICAL CENTER SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT RAFER BENIG M.D. (PRESIDENT)
(773) 445-8155
Entity
Organization
Contact information
Practice address
1222 W 95TH ST, CHICAGO, IL 60643-1408
(773) 445-8155
(773) 779-7186
Mailing address
1222 W 95TH ST, CHICAGO, IL 60643-1408
(773) 445-8155
(773) 779-7186
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
IL
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001635931
BCBS GROUP #
IL
01
—
DE3749
RAILROAD MEDICARE GRP#
IL
01
—
N276702
CORAZON BENIG'S HARMONY#
IL
01
—
P00288775
VINCENT BENIG-RRM PIN
IL
01
—
P00299437
CORAZON BENIG'S RRM PIN
IL
Enumeration date
02/20/2007
Last updated
09/11/2025
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