Provider Demographics
NPI:1700951241
Name:BENDER, CYNTHIA (NP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:BENDER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 N LAKE SHORE DR STE 1000
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-8709
Mailing Address - Country:US
Mailing Address - Phone:312-695-9797
Mailing Address - Fax:312-695-0050
Practice Address - Street 1:675 N. ST. CLAIR GALTER 19-100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-695-4965
Practice Address - Fax:312-695-6660
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209006043363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL962341Medicare PIN
ILQ73553Medicare UPIN
ILK33389Medicare PIN
ILP00401135Medicare PIN
ILK33388Medicare PIN