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NPI Code Detail

MEDICARE: BENJAMIN P LIU M.D.

MEDICARE: BENJAMIN P LIU M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085N0700XNeuroradiology Physician036.118191IL

General Provider Information

NPI Number : 1285740043
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN P LIU M.D.
Provider Business Mailing Address
First Line : 676 N SAINT CLAIR ST FL 14
Second Line : DEPT NEURORADIOLOGY
City : CHICAGO
State : IL
Zip : 60611-2951
Country : US
Telephone Number : 312-695-1292
Fax Number :
Provider Business Practice Location Address
First Line : 676 N SAINT CLAIR ST FL 14
Second Line : DEPT NEURORADIOLOGY
City : CHICAGO
State : IL
Zip : 60611-2951
Country : US
Telephone Number : 312-695-1292
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2006
Last Update Date : 07/09/2008

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Directions to “ BENJAMIN P LIU M.D.” Practice Location

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