Provider Demographics
NPI:1124804018
Name:SENDO, BENJAMIN MARTIN (PHARMD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:MARTIN
Last Name:SENDO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-4760
Mailing Address - Country:US
Mailing Address - Phone:847-825-7194
Mailing Address - Fax:
Practice Address - Street 1:800 DEVON AVE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-4760
Practice Address - Country:US
Practice Address - Phone:847-825-7194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0511305760183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist