Provider Demographics
NPI:1215924410
Name:BENYAMIN, RAMSIN (MD, DABPM, FIPP)
Entity type:Individual
Prefix:DR
First Name:RAMSIN
Middle Name:
Last Name:BENYAMIN
Suffix:
Gender:M
Credentials:MD, DABPM, FIPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 S MERCER AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-7107
Mailing Address - Country:US
Mailing Address - Phone:309-662-4321
Mailing Address - Fax:309-661-4532
Practice Address - Street 1:1015 S MERCER AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-7107
Practice Address - Country:US
Practice Address - Phone:309-662-4321
Practice Address - Fax:309-661-4532
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036085702208VP0014X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL050091313OtherRAILROAD MEDICARE
IL036085702Medicaid
ILF62150Medicare UPIN
ILL99748Medicare PIN
IL050091313OtherRAILROAD MEDICARE