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General NPI Number Information
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NPI Number | 1235685801
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Entity Type | Individual
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Provider Name | BENJAMIN SCHWABE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 120 OAKBROOK CTR STE 714
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City | OAK BROOK
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State | IL
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Zip | 60523-1831
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Country | US
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Telephone | 630-654-3331
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Fax |
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Provider Business Mailing Address
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Address Line | 120 OAKBROOK CTR STE 714
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City | OAK BROOK
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State | IL
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Zip | 60523-1831
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 1001317-15
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.034073
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License Number State | IL
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