Dale K Benton, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

041247783 Issued in IL

Practice address

641 W 63Rd St
Chicago, IL 60621-2032

Phone

(312) 996-2000

NPI assigned

Nov 17, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dbenton16891@uihealth.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment NPD
• The Board of Trustees of the University of Illinois

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• The Board of Trustees of the University of Illinois

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1669493466
  NPD
• The Board of Trustees of the University of Illinois

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1952713323
  NPD
• Avanti Medical Group of Illinois LLC

  • Clinic/Center
  • Wheaton, IL
  • NPI 1609185875
  NPD (past)
• Board of Trustees of the University of Illinois

  • Pediatrics Physician
  • Peoria, IL
  • NPI 1467425322
  NPD (past)
• Emergency Room Care Providers, S.C.

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1417990219
  NPD (past)

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1316274012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606212032",
            "telephone_number": "312-996-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606212032",
            "telephone_number": "312-996-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTON",
        "first_name": "DALE",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-17",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209007705",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "041247783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363799834005",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas R Benthien, O.D.
• Beth Brockman Bentley, MS OTR/L
• Chantel Bentley
• Heather Bentley, AU.D
• Bentleys Helping Hand Adult Day Services
• David Bentrem, MD
• Allison Bentz
• Russell G Benuck, M.D.
• Ellen C Benya, M.D.
• Richard V. Benya

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.