Organization
JIL MEDICAL CONSULTANT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DESSA BENTON REGISTERED NURSE (ADVANCE PRACTICE NURSE)
(773) 776-8800
Entity
Organization
Contact information
Practice address
5500 S DAMEN AVE, CHICAGO, IL 60636-1107
(773) 776-8800
(773) 776-8801
Mailing address
5500 S DAMEN AVE, CHICAGO, IL 60636-1107
(773) 776-8800
(773) 776-8801
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
036-09434
IL
Other
Enumeration date
06/27/2008
Last updated
06/27/2008
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