MEDICARE: MS. FRAN BENDER APN/CNP

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	363LW0102X	Women's Health Nurse Practitioner	209.006245	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	209.006245	OTHER	IL	ILLINOIS APN LICENSE

General Provider Information

NPI Number	:	1558449942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. FRAN BENDER APN/CNP

Provider Business Mailing Address
First Line	:	2001 S CALIFORNIA AVE STE 100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-2486
Country	:	US
Telephone Number	:	773-640-5797
Fax Number	:

Provider Business Practice Location Address
First Line	:	3059 W 26TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623
Country	:	US
Telephone Number	:	773-584-6200
Fax Number	:

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	02/25/2019

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