Individual
JOSEPH CARL G BENAVIDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 DEER POINTE DR, SOUTH ELGIN, IL 60177-1342
(630) 723-8730
Mailing address
1201 DEER POINTE DR, SOUTH ELGIN, IL 60177-1342
(630) 723-8730
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056.013876
IL
Other
Enumeration date
02/08/2021
Last updated
02/08/2021
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