Healthcare Provider Details

I. General information

NPI: 1518547363
Provider Name (Legal Business Name): BENJAMIN JACOB KATZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 GOLF RD STE 300
DES PLAINES IL
60016-4029
US

IV. Provider business mailing address

8901 GOLF RD STE 300
DES PLAINES IL
60016-4029
US

V. Phone/Fax

Practice location:
  • Phone: 847-824-3127
  • Fax:
Mailing address:
  • Phone: 847-824-3127
  • Fax: 847-824-3347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number036181751
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: