Individual
DR. JORGE ALBERTO BENAVIDES VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4646 N MARINE DR, CHICAGO, IL 60640-5759
(773) 878-8700
Mailing address
4541 N SHERIDAN RD, APT 505, CHICAGO, IL 60640-5651
(215) 410-1409
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125.063560
IL
Other
Enumeration date
08/05/2013
Last updated
08/05/2013
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