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NPI Code Detail

MEDICARE: MS. JENNIFER BENSON MS CNM

MEDICARE: MS. JENNIFER BENSON MS CNM
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
1367A00000XAdvanced Practice Midwife209004580IL
2367A00000XAdvanced Practice Midwife485MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101621679OTHERIDBCBS OF IL

General Provider Information

NPI Number : 1619950284
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER BENSON MS CNM
Provider Business Mailing Address
First Line : 200 1ST ST SW
Second Line :
City : ROCHESTER
State : MN
Zip : 55905-0001
Country : US
Telephone Number : 507-284-2511
Fax Number : 312-328-7895
Provider Business Practice Location Address
First Line : 5525 S MICHIGAN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60637-1012
Country : US
Telephone Number : 773-585-1955
Fax Number : 773-284-5268
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2005
Last Update Date : 03/04/2022

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