Benjamin L Lockwood
Individual provider Active NPI Surgical Assistant · Alsip, IL
NPI 1447131024 · NPPES record last updated Sep 10, 2025
Key facts
- NPI
- 1447131024
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Assistant 246ZC0007X
- License
- 238.000704 (IL)
- Practice address
- 3930 W 115TH PL Apt 2B
Alsip, IL 60803-6229 - Phone
- (312) 721-7863
- NPI assigned
- Sep 10, 2025
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 238.000704 | IL | MD | Surgical Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 238.000704 | IL | Yes |
Addresses
Primary practice location
3930 W 115TH PL Apt 2B
Alsip, IL 60803-6229
Mailing address
3930 W 115TH PL Apt 2B
Alsip, IL 60803-6229
Phone (312) 721-7863
Other providers in Alsip, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.