Mari Benitez, DPM, SC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016005165 Issued in IL

Legal business name

MARI BENITEZ, DPM, SC

Practice address

2504 Washington St
Suite 505
Waukegan, IL 60085-4983

Phone

(847) 336-9930

Fax

(847) 336-9937

NPI assigned

Jun 30, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Mari Benitez, DPM

Title

Doctor

Phone

(847) 207-3500

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19393/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marisenda Benitez, DPM

  • Foot Surgery Podiatrist
  • Waukegan, IL
  • NPI 1336115864
  Medicare reassignment NPD
• Pranshu A Adavadkar, MD

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1427073352
  NPD
• Avani Ajay Patel, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hickory Hills, IL
  • NPI 1962160572
  NPD

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434067200000",
    "number": "1942438759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 WASHINGTON ST",
            "address_2": "SUITE 505",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854983",
            "telephone_number": "847-336-9930",
            "fax_number": "847-336-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 WASHINGTON ST",
            "address_2": "SUITE 505",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854983",
            "telephone_number": "847-336-9930",
            "fax_number": "847-336-9937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARI BENITEZ, DPM, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2015-06-12",
        "status": "A",
        "authorized_official_last_name": "BENITEZ",
        "authorized_official_first_name": "MARI",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "847-207-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016005165",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rodrigo Manjarres, MA
• Amber Nicole Manley, MA
• Agatona Villegas Marasigan, RN
• Karina Itzel Marban
• Eugene Carroll Marceron Jr., LCSW
• Andrea Marinho
• Loolul Marjan, DMD
• Jacqueline Marolt, LCSW
• Elizabeth Marrero
• Alyson Genell Marsalis, LCPC

• Foot & Ankle Surgery Podiatrist in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.