Provider Demographics
NPI:1659367670
Name:BENRUBI, PERLA M (MD)
Entity Type:Individual
Prefix:DR
First Name:PERLA
Middle Name:M
Last Name:BENRUBI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:676 N SAINT CLAIR ST
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2927
Mailing Address - Country:US
Mailing Address - Phone:312-926-6000
Mailing Address - Fax:312-926-6344
Practice Address - Street 1:676 N SAINT CLAIR ST
Practice Address - Street 2:SUITE 2300
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2927
Practice Address - Country:US
Practice Address - Phone:312-926-6000
Practice Address - Fax:312-926-6344
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2013-01-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036062641207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1617522OtherBCBS
IL060022779OtherRAILROAD MEDICARE
IL238966OtherHARMONY OF IL
ILP09892OtherMEDICARE PTAN
ILK48915OtherMEDICARE PTAN
IL036062641Medicaid
ILD14803Medicare UPIN