Healthcare Provider Details

I. General information

NPI: 1316566698
Provider Name (Legal Business Name): BENJAMIN MARK STRICKLAND DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: BEN STRICKLAND DO

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 W NORTH AVE STE 402
MELROSE PARK IL
60160-1624
US

IV. Provider business mailing address

120 W 22ND ST
OAK BROOK IL
60523-1557
US

V. Phone/Fax

Practice location:
  • Phone: 708-450-4551
  • Fax:
Mailing address:
  • Phone: 630-573-5000
  • Fax: 630-368-0280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number036.164449
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.164449
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number036.164449
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: