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General NPI Number Information
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NPI Number | 1821353533
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Entity Type | Individual
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Provider Name | BENJAMIN DILLE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/09/2012
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 4500 UTICA RIDGE RD
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City | BETTENDORF
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State | IA
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Zip | 52722-1626
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Country | US
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Telephone | 773-454-3785
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Fax |
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Provider Business Mailing Address
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Address Line | 5709 N RAVENSWOOD AVE
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City | CHICAGO
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State | IL
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Zip | 60660-3913
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Country | US
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Telephone | 773-454-3785
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | MD-48986
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License Number State | IA
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