Individual
DR. JORGE A BENAVENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTOMETRIST PC
Contact information
Practice address
9175 CALUMET AVE, MUNSTER, IN 46321-2805
(219) 836-7800
(219) 836-4806
Mailing address
9175 CALUMET AVE, MUNSTER, IN 46321-2805
(219) 836-7800
(219) 836-4806
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046-0006940
IL
152W00000X
Optometrist
Primary
18001807B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100157520A
—
IN
01
—
351517961
TAX ID
IN
Enumeration date
09/20/2006
Last updated
08/15/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us