Bennu Health Service

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BENNU HEALTH SERVICE

Practice address

2617 W 71St St
Chicago, IL 60629-2003

Phone

(773) 354-7572

NPI assigned

Apr 22, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kimberly Gray-White, M.D.

Title

President

Phone

(773) 354-7572

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164640611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125A E HYDE PARK BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606152809",
            "telephone_number": "773-354-7572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 W 71ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606292003",
            "telephone_number": "773-354-7572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENNU HEALTH SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAY-WHITE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-354-7572",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Lenore Bennett
• Elizabeth Benney, MA DT CIMI
• Mohamed Bennij, FNP
• Molly Chima Benning
• Elizabeth Denae Bennion-Isenberg, MSW
• Jean-Luc Benoit
• Jenna Michelle Benoit, PA-C
• Stephany A Benoy, PT, DPT
• Perla M Benrubi, MD
• Katharine Bensinger, LCPC

• Community/Behavioral Health Agency in Chicago, IL
• Providers in Chicago, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.