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NPI Code Detail

MEDICARE: MR. CHARLES STEVEN BENAIN RPH

MEDICARE:  MR. CHARLES STEVEN BENAIN  RPH
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
1183500000XPharmacistIL

General Provider Information

NPI Number : 1821154410
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHARLES STEVEN BENAIN RPH
Provider Business Mailing Address
First Line : 5061 N PULASKI RD
Second Line : 3RD FLOOR
City : CHICAGO
State : IL
Zip : 60630-2706
Country : US
Telephone Number : 773-463-2157
Fax Number : 773-463-2583
Provider Business Practice Location Address
First Line : 5061 N PULASKI RD
Second Line : 3RD FLOOR
City : CHICAGO
State : IL
Zip : 60630-2706
Country : US
Telephone Number : 773-463-2157
Fax Number : 773-463-2583
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2006
Last Update Date : 07/08/2007

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Directions to “ MR. CHARLES STEVEN BENAIN RPH” Practice Location

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