MEDICARE: MANJU BENNY NP

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
1	363LG0600X	Gerontology Nurse Practitioner	209034081	IL

General Provider Information

NPI Number	:	1598628067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANJU BENNY NP

Provider Business Mailing Address
First Line	:	913 E IRONWOOD DR
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-1359
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	913 E IRONWOOD DR
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-1359
Country	:	US
Telephone Number	:	847-863-1179
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

Similar Medicare Providers

1447793203 — PHILOMINA KALATHIL AUGUSTINE FNP
Practice Location Address:

917 E IRONWOOD DR
MOUNT PROSPECT, IL
60056-1359

Practice Phone: 847-368-9646
Practice Fax:

1164842399 — JENNIFER DAVIS R.N., IBCLC
Practice Location Address:

12 PROSPECT AVE
RANDOLPH, VT
05060-1359

Practice Phone: 802-728-4105
Practice Fax:

1760417323 — WESCO MEDICAL SUPPLY&EQUIPMENT CO
Practice Location Address:

1359 N MOUNT VERNON AVE
COLTON, CA
92324-2561

Practice Phone: 909-370-0335
Practice Fax:

1861505703 — DAVID Y LEE MD
Practice Location Address:

1359 N MOUNT AUBURN RD
CAPE GIRARDEAU, MO
63701-1727

Practice Phone: 573-651-3188
Practice Fax: 573-651-3048

1649365917 — ROBERT EARL GARDNER JR. MD
Practice Location Address:

1359 N MOUNT AUBURN RD
CAPE GIRARDEAU, MO
63701-1727

Practice Phone: 573-651-3188
Practice Fax: 573-651-3048

1487712295 — DR. CHARLES M. MOON MD
Practice Location Address:

1359 N MOUNT AUBURN RD
CAPE GIRARDEAU, MO
63701-1727

Practice Phone: 573-335-7546
Practice Fax: 573-335-7550

Directions to “ MANJU BENNY NP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.