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NPI Code Detail

MEDICARE: BENJAMIN HILL TUDOR

MEDICARE: BENJAMIN HILL TUDOR
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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1417439621
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN HILL TUDOR
Provider Business Mailing Address
First Line : 77 W WASHINGTON ST STE 1500
Second Line :
City : CHICAGO
State : IL
Zip : 60602-3219
Country : US
Telephone Number : 773-980-9679
Fax Number :
Provider Business Practice Location Address
First Line : 77 W WASHINGTON ST STE 1500
Second Line :
City : CHICAGO
State : IL
Zip : 60602-3219
Country : US
Telephone Number : 773-980-9679
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2018
Last Update Date : 07/15/2024

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Directions to “ BENJAMIN HILL TUDOR ” Practice Location

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