Healthcare Provider Details

I. General information

NPI: 1740825934
Provider Name (Legal Business Name): AUBREY BENTON MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2019
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E WILSON ST STE 180
BATAVIA IL
60510-3168
US

IV. Provider business mailing address

1001 E WILSON ST STE 180
BATAVIA IL
60510-3168
US

V. Phone/Fax

Practice location:
  • Phone: 630-879-1091
  • Fax:
Mailing address:
  • Phone: 630-879-1091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.103974
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.025066
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number124496
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: