Provider Demographics
NPI:1245742949
Name:BENEDECK, JILL C (APRN, CNS)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:C
Last Name:BENEDECK
Suffix:
Gender:F
Credentials:APRN, CNS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4305 W MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-8425
Mailing Address - Country:US
Mailing Address - Phone:815-344-8000
Mailing Address - Fax:815-344-9601
Practice Address - Street 1:4305 W MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-8425
Practice Address - Country:US
Practice Address - Phone:815-344-8000
Practice Address - Fax:815-344-9601
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209016560364S00000X
IL209.016560364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist