Individual provider Active NPI

Ellen C Benya, M.D.

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1497755565
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036.078263 Issued in IL
Practice address
225 E Chicago Ave # 9
Chicago, IL 60611-2991
Phone
(312) 227-4500
Fax
(312) 227-9785
NPI assigned
Jul 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 036078263 IL
Diagnostic Radiology Physician 2085R0202X 036.078263 IL Primary

Addresses

Primary practice location

225 E Chicago Ave # 9
Chicago, IL 60611-2991

Mailing address

225 E Chicago Ave # 9
Chicago, IL 60611-2991
Phone (312) 227-4500

Other identifiers 2

IdentifierTypeStateIssuer
021622158OtherILCMMG BLUE SHIELD
036078263MedicaidIL

Other names 1

  • Dr. Ellen C Anderson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ebenya@luriechildrens.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
I20131011000543 IL Practitioner - Diagnostic RadiologyPractitioner - Geriatric Medicine 7810121571 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036078263ILMDPediatric Radiology Physician
036.078263ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children Current Accepting new patients
Shriners Hospitals for Children CurrentSince Jun 5, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Mar 4, 2015 Accepting new patients
Northwestern Medical Faculty Foundation Pediatric Radiology CurrentSince Mar 4, 2015 Accepting new patients
Shriners Hospitals for Children CurrentSince Jun 5, 2020 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-6415

225 E Chicago Ave
#9
Chicago, IL 60611
Phone (312) 227-4500

2211 N Oak Park Ave
Chicago, IL 60707
Phone (773) 385-5463

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1497755565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE # 9",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-4500",
            "fax_number": "312-227-9785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE # 9",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-4500",
            "fax_number": "312-227-9785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENYA",
        "first_name": "ELLEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-29",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "IL",
            "license": "036078263",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036.078263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMMG BLUE SHIELD",
            "identifier": "021622158",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036078263",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ebenya@luriechildrens.org",
            "affiliation": "N",
            "address_1": "225 E Chicago Ave # 9",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606112991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "ANDERSON",
            "middle_name": "C",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.