Healthcare Provider Details

I. General information

NPI: 1346263647
Provider Name (Legal Business Name): PAULA SUE BENES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3402 ANDERSON HEALTHCARE DR
EDWARDSVILLE IL
62025-7712
US

IV. Provider business mailing address

1776 WOODSTEAD CT STE 208
THE WOODLANDS TX
77380-1480
US

V. Phone/Fax

Practice location:
  • Phone: 877-749-7428
  • Fax: 512-628-3314
Mailing address:
  • Phone: 877-749-7428
  • Fax: 877-749-7428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2016016252
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number036.168593
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number036.168593
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: