Provider Demographics
NPI:1508667155
Name:BENT, DANIELLE (STUDENT)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BENT
Suffix:
Gender:F
Credentials:STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 E GREENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-1522
Mailing Address - Country:US
Mailing Address - Phone:773-567-7841
Mailing Address - Fax:
Practice Address - Street 1:325 PITTSBORO ST # 3550
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-2911
Practice Address - Country:US
Practice Address - Phone:919-962-4366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program