Provider Demographics
NPI:1346668019
Name:BENCK, LILLIAN ROCHELLE (MD)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:ROCHELLE
Last Name:BENCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LILLIAN
Other - Middle Name:
Other - Last Name:BERNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2151 WAUKEGAN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BANNOCKBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60015-1885
Mailing Address - Country:US
Mailing Address - Phone:847-663-8410
Mailing Address - Fax:847-676-1727
Practice Address - Street 1:2151 WAUKEGAN RD STE 100
Practice Address - Street 2:
Practice Address - City:BANNOCKBURN
Practice Address - State:IL
Practice Address - Zip Code:60015-1885
Practice Address - Country:US
Practice Address - Phone:847-663-8410
Practice Address - Fax:847-676-1727
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036157296207RA0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease