Individual provider Active NPI

Janice Louise Benson, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1407977101
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-063435 Issued in IL
Practice address
1901 W Harrison St
Chicago, IL 60612-3714
Phone
(312) 864-3500
Fax
(312) 864-9912
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-063435 IL Primary

Addresses

Primary practice location

1901 W Harrison St
Chicago, IL 60612-3714

Mailing address

4452 N Francisco Ave
Chicago, IL 60625-3807
Phone (312) 864-3505

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbenson226107@direct.northshore.org

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110214000032 IL Practitioner - Family Practice 9436339116 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-063435ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Family Health Center, Inc Current Accepting new patients
Erie Family Health Center Inc CurrentSince Feb 10, 2020 Accepting new patients
Endeavor Health Medical Group Family Medicine CurrentSince Dec 20, 2010 Accepting new patients
Erie Family Health Center Inc CurrentSince Feb 10, 2020 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 20, 2010 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

1504 S Albany Ave
Chicago, IL 60623

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

1285 Hartrey Ave
Evanston, IL 60202
Phone (847) 666-2302

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Interoperability endpoints

  • Direct secure messaging: jbenson226107@direct.northshore.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1407977101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4452 N FRANCISCO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253807",
            "telephone_number": "312-864-3505",
            "fax_number": "312-864-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-3500",
            "fax_number": "312-864-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "JANICE",
        "middle_name": "LOUISE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-063435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbenson226107@direct.northshore.org",
            "affiliation": "N",
            "address_1": "1901 W Harrison St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.