Individual
BENJAMIN J. SIGWARTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3249 OAK PARK AVE, BERWYN, IL 60402-3429
(708) 783-6000
Mailing address
3249 OAK PARK AVE, BERWYN, IL 60402-3429
(708) 783-6000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10001062A
IN
363AM0700X
Medical Physician Assistant
Primary
085-002995
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000616964
ANTHEM PROVIDER NUMBER
IN
Enumeration date
08/08/2007
Last updated
12/02/2015
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