Provider Demographics
NPI:1093988321
Name:P W BENESHUNAS ENTERPRISES LTD
Entity Type:Organization
Organization Name:P W BENESHUNAS ENTERPRISES LTD
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BENESHUNAS
Authorized Official - Suffix:
Authorized Official - Credentials:PEDORTHIST
Authorized Official - Phone:630-357-0992
Mailing Address - Street 1:931 W 75TH ST
Mailing Address - Street 2:SUITE 133
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-1294
Mailing Address - Country:US
Mailing Address - Phone:630-357-0992
Mailing Address - Fax:630-357-3503
Practice Address - Street 1:931 W 75TH ST
Practice Address - Street 2:SUITE 133
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-1294
Practice Address - Country:US
Practice Address - Phone:630-357-0992
Practice Address - Fax:630-357-3503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4350560001Medicare NSC