Jonathan David Benson, D.O.
Individual provider Active NPI Family Medicine Physician · Normal, IL
NPI 1972887982 · NPPES record last updated Jul 12, 2018
Key facts
- NPI
- 1972887982
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036.130914 (IL)
- Practice address
- 1300 Franklin Avenue, Suite 100
Normal, IL 61761 - Phone
- (309) 268-3761
- NPI assigned
- Oct 10, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Kansas City University of Med & Biosciences, College of Osteo Med, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- South Sound Inpatient Physicians PLLC
Practice addresses (Care Compare)
400 NE Mother Joseph PL
Vancouver, WA 98664-3200
Phone (360) 514-3727
Hospital & facility affiliations
- Peacehealth Southwest Medical Cente
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL, WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130208000357 | IL | Practitioner - Family Practice | 1759535214 | Reassigns benefits to 4 organizations |
| I20260306002873 | WA | Practitioner - Family Practice | 1759535214 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.130914 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Sound Inpatient Physicians, PLLC | Family Medicine | Current |
Accepting new patients |
| Carle Bromenn Medical Center | Current |
Accepting new patients | |
| South Sound Inpatient Physicians PLLC | Family Medicine | Current |
Accepting new patients |
| Carle West Physician Group Inc | Family Medicine | Current |
Accepting new patients |
| Carle Bromenn Medical Center | Current |
Accepting new patients | |
| Sound Physicians of Illinois, LLC | Family Medicine | Current |
Accepting new patients |
| Advocate Health and Hospitals Corporation | Current |
Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current |
Accepting new patients | |
| Peacehealth | Family Medicine | Past | Accepting new patients |
| Dermatology and Skin Cancer Center | Past |
Accepting new patients | |
| Cogent Healthcare of Illinois, LLC | Family Medicine | Past | Accepting new patients |
Locations
2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
29373 Network Pl
Chicago, IL 60673
1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227
8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500
1300 Franklin Ave
Ste 100
Normal, IL 61761
Phone (309) 268-3503
1300 Franklin Ave
Ste 380
Normal, IL 61761
Phone (309) 268-3589
1304 Franklin Ave
Normal, IL 61761
Phone (309) 268-3590
20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857
1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036.130914 | IL | Yes |
Addresses
Primary practice location
1300 Franklin Avenue, Suite 100
Normal, IL 61761
Mailing address
20141 Sterling Rd
Bloomington, IL 61705-5328
Phone (309) 532-0009
Other providers in Normal, IL
- Kathryn Bell
- James Arthur Bellman Jr.
- Denise E Bennett
- Andrew Benning
- Ashley Benson
- Mark Andrew Benson
- Jennifer Alice Berkley
- Allison Berndt
- Kathy Jo Berry
- Deborah R Berryman
All providers in Normal, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.