Provider Demographics
NPI:1790399244
Name:SOLAYMAN, BENJAMIN (RN)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:SOLAYMAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 E 22ND ST STE 217
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-6176
Mailing Address - Country:US
Mailing Address - Phone:630-519-4744
Mailing Address - Fax:
Practice Address - Street 1:450 E 22ND ST STE 217
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-6176
Practice Address - Country:US
Practice Address - Phone:630-519-4744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL41372439163W00000X
IL041372439163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse