Mark G Benedict, RN

Individual provider Active NPI Critical Care Medicine Registered Nurse · Greenfield, IL

NPI 1154558542 · NPPES record last updated Jun 12, 2009

Key facts

NPI
1154558542
Entity type
Individual (NPI type 1)
Primary specialty
Critical Care Medicine Registered Nurse 163WC0200X
License
041314705 (IL)
Practice address
519 Main St
Greenfield, IL 62044-1321
Phone
(217) 358-3075
NPI assigned
Jun 12, 2009
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041314705ILMDCritical Care Medicine Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 041314705 IL Yes

Addresses

Primary practice location

519 Main St
Greenfield, IL 62044-1321

Mailing address

519 Main St
Greenfield, IL 62044-1321
Phone (217) 358-3075

Other providers in Greenfield, IL

All providers in Greenfield, IL · Critical Care Medicine Registered Nurse in Illinois

Sources for this page

Verify at the official NPI Registry.