Organization
MARI BENITEZ, DPM, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARI BENITEZ DPM (DOCTOR)
(847) 207-3500
Entity
Organization
Contact information
Practice address
2504 WASHINGTON ST, SUITE 505, WAUKEGAN, IL 60085-4983
(847) 336-9930
(847) 336-9937
Mailing address
2504 WASHINGTON ST, SUITE 505, WAUKEGAN, IL 60085-4983
(847) 336-9930
(847) 336-9937
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016005165
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016005165
—
IL
Enumeration date
06/30/2009
Last updated
06/12/2015
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