Diann D Bennett, MD

Individual provider Active NPI Internal Medicine Physician · Freeport, IL

NPI 1326010083 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1326010083
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
Practice address
25 N Harlem Ave
Freeport, IL 61032-3801
Phone
(815) 599-6000
NPI assigned
Feb 6, 2006
Sex
Female
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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036107289ILMDInternal Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X IL Yes

Addresses

Primary practice location

25 N Harlem Ave
Freeport, IL 61032-3801

Mailing address

421 W Exchange St
PO Box 268
Freeport, IL 61032-4030

Other providers in Freeport, IL

All providers in Freeport, IL · Internal Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.