Provider Demographics
NPI:1962752899
Name:VILLAFANE, BENJAMIN JR (LAB TECHNICIAN)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:
Last Name:VILLAFANE
Suffix:JR
Gender:M
Credentials:LAB TECHNICIAN
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Mailing Address - Street 1:9243 S ROBERTS RD
Mailing Address - Street 2:2R
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-2079
Mailing Address - Country:US
Mailing Address - Phone:708-907-5694
Mailing Address - Fax:773-751-2250
Practice Address - Street 1:9243 S ROBERTS RD
Practice Address - Street 2:2R
Practice Address - City:HICKORY HILLS
Practice Address - State:IL
Practice Address - Zip Code:60457-2079
Practice Address - Country:US
Practice Address - Phone:708-907-5694
Practice Address - Fax:773-751-2250
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246R00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Pathology