Provider Demographics
NPI:1841385713
Name:BENKO CHIROPRACTIC CENTER P.C.
Entity Type:Organization
Organization Name:BENKO CHIROPRACTIC CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BENKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:219-322-9999
Mailing Address - Street 1:142 W US HIGHWAY 30
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-1852
Mailing Address - Country:US
Mailing Address - Phone:219-322-9999
Mailing Address - Fax:219-322-9999
Practice Address - Street 1:142 W US HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-1852
Practice Address - Country:US
Practice Address - Phone:219-322-9999
Practice Address - Fax:219-322-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000091026OtherBLUE CROSS/ANTHEM
IL90000265OtherBLUE CROSS BLUE SHIELD
IL90000265OtherBLUE CROSS BLUE SHIELD
INBE404930Medicare ID - Type Unspecified