MEDICARE: DR. LISA ANN BENNING M.D.

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	207R00000X	Internal Medicine Physician	036078400	IL
2	208M00000X	Hospitalist Physician	036078400	IL

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	:	1689672289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA ANN BENNING M.D.

Provider Business Mailing Address
First Line	:	1025 S 6TH ST
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62703-2403
Country	:	US
Telephone Number	:	217-528-7541
Fax Number	:	217-528-8962

Provider Business Practice Location Address
First Line	:	701 N 1ST ST
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62702-3757
Country	:	US
Telephone Number	:	217-528-7541
Fax Number	:	217-753-0815

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	09/25/2013

Similar Medicare Providers

1467527317 — DR. MICHAEL B HALLE MD
Practice Location Address:

2101 E JEFFERSON ST , KAISER PERMANENTE SPRINGFIELD MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 701-922-1000
Practice Fax: 703-922-1039

1134964174 — ANTHONY THOMAS MD
Practice Location Address:

701 N 1ST ST STE D220
SPRINGFIELD, IL
62702-3757

Practice Phone: 217-545-8000
Practice Fax: 217-545-2711

1508799164 — ABIGAIL ROSE KAPPENMAN DO
Practice Location Address:

701 N 1ST ST STE D220
SPRINGFIELD, IL
62702-3757

Practice Phone: 217-545-8000
Practice Fax: 217-545-2711

1437235314 — DR. SCOTT BERGMAN PHARM.D.
Practice Location Address:

701 N 1ST ST # 19636 , SIU INFECTIOUS DISEASES
SPRINGFIELD, IL
62702-3757

Practice Phone: 217-545-4040
Practice Fax: 217-545-8025

1275691966 — KATHRYN S LEVIN RD
Practice Location Address:

701 N 1ST ST
SPRINGFIELD, IL
62702-3757

Practice Phone: 217-788-3477
Practice Fax: 217-788-5569

1649492968 — APARNA SURYADEVARA MD
Practice Location Address:

701 N 1ST ST
SPRINGFIELD, IL
62702-3757

Practice Phone: 217-545-0182
Practice Fax: 217-545-4735

Directions to “ DR. LISA ANN BENNING M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.