Provider Demographics
NPI:1780482745
Name:BENEDICT, JADEN MONEA
Entity type:Individual
Prefix:
First Name:JADEN
Middle Name:MONEA
Last Name:BENEDICT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 N SACRAMENTO BLVD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-1046
Mailing Address - Country:US
Mailing Address - Phone:773-265-1539
Mailing Address - Fax:
Practice Address - Street 1:700 N SACRAMENTO BLVD STE 201
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-1058
Practice Address - Country:US
Practice Address - Phone:773-265-1539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician