MEDICARE: BENJAMIN EZSIAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	03801448	IL

General Provider Information

NPI Number	:	1215886999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN EZSIAS

Provider Business Mailing Address
First Line	:	1678 59TH PL
Second Line	:
City	:	LA GRANGE HIGHLANDS
State	:	IL
Zip	:	60525-3747
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1749 N WELLS ST STE LOBBY
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-8777
Country	:	US
Telephone Number	:	312-440-9646
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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Directions to “ BENJAMIN EZSIAS ” Practice Location

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