Healthcare Provider Details

I. General information

NPI: 1750313177
Provider Name (Legal Business Name): BENJAMIN TOH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 01/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 S MILLER ST SUITE 1
CHICAGO IL
60607-4207
US

IV. Provider business mailing address

826 S MILLER ST SUITE 1
CHICAGO IL
60607-4207
US

V. Phone/Fax

Practice location:
  • Phone: 312-733-9010
  • Fax:
Mailing address:
  • Phone: 312-733-9010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036064319
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: