Healthcare Provider Details

I. General information

NPI: 1396997631
Provider Name (Legal Business Name): ERIN JEAN BENEDETTI PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2008
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 S RANDALL RD
NORTH AURORA IL
60542-1585
US

IV. Provider business mailing address

35 S RANDALL RD
NORTH AURORA IL
60542-1585
US

V. Phone/Fax

Practice location:
  • Phone: 630-892-8003
  • Fax: 630-518-4874
Mailing address:
  • Phone: 630-892-8003
  • Fax: 630-518-4874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number160.004757
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: