MEDICARE: DR. LILLI BENCK DC

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	DC-04808	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396215265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LILLI BENCK DC

Provider Business Mailing Address
First Line	:	117 SOLON RD
Second Line	:
City	:	CHAGRIN FALLS
State	:	OH
Zip	:	44022-3120
Country	:	US
Telephone Number	:	540-577-4752
Fax Number	:

Provider Business Practice Location Address
First Line	:	25001 EMERY RD
Second Line	:
City	:	WARRENSVILLE HEIGHTS
State	:	OH
Zip	:	44128-5626
Country	:	US
Telephone Number	:	540-577-4752
Fax Number	:

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

Provider Enumeration Date	:	12/04/2018
Last Update Date	:	10/11/2021

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Directions to “ DR. LILLI BENCK DC” Practice Location

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