Benjamin Jeng-Shing Wang, MD PHD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036061248 Issued in IL

Practice address

80 River Oaks
Ste 813
Calumet City, IL 60409

Phone

(708) 862-5783

Fax

(708) 862-5784

NPI assigned

Sep 2, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1962496182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 RIVER OAKS",
            "address_2": "STE 813",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "60409",
            "telephone_number": "708-862-5783",
            "fax_number": "708-862-5784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 RIVER OAKS",
            "address_2": "STE 813",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "60409",
            "telephone_number": "708-862-5783",
            "fax_number": "708-862-5784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "BENJAMIN",
        "middle_name": "JENG-SHING",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2010-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036061248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4029169",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061248",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0031600025",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Milijana Vukobrat, PHARM D
• Itasca L Waiters, D.C
• Walgreen Co
• Walgreen Co.
• Kyle Walther, PHARMD
• Shayna Watkins
• Stacey Weathers-Cannon
• Jasmin Weaver
• Jan Renee Weeden
• Michael Peter Weisberg, M.D.

• Internal Medicine Physician in Calumet City, IL
• Providers in Calumet City, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.