Individual
DR. BENJAMIN COHEN GERSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 W. PARK ST., URBANA, IL 61801-2500
(217) 383-3431
(217) 383-7117
Mailing address
611 W. PARK ST., FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2011-00818
NC
2084P0800X
Psychiatry Physician
Primary
036138542
IL
2084P0800X
Psychiatry Physician
2011-00818
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
165FY
BCBSNC
NC
05
—
5918528
—
NC
Enumeration date
07/18/2007
Last updated
02/04/2021
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