Provider Demographics
NPI:1912915596
Name:BENSON, RODNEY J (PHD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:J
Last Name:BENSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 N KINGSBURY ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-2687
Mailing Address - Country:US
Mailing Address - Phone:773-494-5505
Mailing Address - Fax:312-867-1242
Practice Address - Street 1:1333 N KINGSBURY ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-2687
Practice Address - Country:US
Practice Address - Phone:773-494-5505
Practice Address - Fax:312-867-1242
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006640103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical