Active NPI
Stefanie Duda Benjamin, MD
- Diagnostic Radiology Physician
- Maywood, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 036104372
- Practice address
- 2160 S 1St Ave
Maywood, IL 60153-3328 - Phone
- (708) 216-9000
- NPI assigned
- Feb 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 036104372 | IL | Primary |
Addresses
Primary practice location
2160 S 1St Ave
Maywood, IL 60153-3328
Mailing address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 168211001 | Other | AR | AR MEDICAID |
| 036104372-4 | Medicaid | IL | |
| P00635664 | Other | TRAVELERS RR MEDICARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sdudabenjamin114210@direct.luhs.org | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000
Hospital & facility affiliations
- Loyola University Medical Center
- Loyola Gottlieb Memorial Hospital
- Macneal Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Loyola University Medical Center | Current | Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients | |
| Metropolitan Advanced Radiological Services, LTD. | Diagnostic Radiology | Past | Accepting new patients |
| Village Radiology LTD | Diagnostic Radiology | Past | Accepting new patients |
Locations
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119
2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400
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.
-
- General Practice Physician
- Maywood, IL
- NPI 1336159961
-
- Community/Retail Pharmacy
- Maywood, IL
- NPI 1184789299
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
-
- Diagnostic Radiology Physician
- Berwyn, IL
- NPI 1689613804
-
- Diagnostic Radiology Physician
- Oak Park, IL
- NPI 1346337565
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Berwyn, IL
- NPI 1295710580
-
- General Acute Care Hospital
- Melrose Park, IL
- NPI 1831170232
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
-
- General Acute Care Hospital
- Tinley Park, IL
- NPI 1427752013
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620345600000",
"number": "1659347482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "708-216-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "708-216-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENJAMIN",
"first_name": "STEFANIE",
"middle_name": "DUDA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-23",
"last_updated": "2021-05-07",
"certification_date": "2021-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036104372",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AR MEDICAID",
"identifier": "168211001",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036104372-4",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRAVELERS RR MEDICARE",
"identifier": "P00635664",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sdudabenjamin114210@direct.luhs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2160 S 1st Ave",
"city": "Maywood",
"state": "IL",
"country_code": "US",
"postal_code": "601533328",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.