Provider Demographics
NPI:1013228204
Name:BENSKO, LEANNE TRAPP (MD)
Entity Type:Individual
Prefix:DR
First Name:LEANNE
Middle Name:TRAPP
Last Name:BENSKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LEANNE
Other - Middle Name:WARD
Other - Last Name:TRAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:680 N LAKE SHORE DR
Mailing Address - Street 2:1050
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4546
Mailing Address - Country:US
Mailing Address - Phone:312-642-5515
Mailing Address - Fax:312-642-0753
Practice Address - Street 1:680 N LAKE SHORE DR
Practice Address - Street 2:1050
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4546
Practice Address - Country:US
Practice Address - Phone:312-642-5515
Practice Address - Fax:312-642-0753
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-058304208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics