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1093825101
JEAN A BENACKER
CHAMPAIGN, IL
NPI
1093825101
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: IL 071003677)
Enumeration Date
2006-08-30
Last Update Date
2010-12-21
Business Address
Dr. JEAN A BENACKER PhD
1701 S PROSPECT AVE SUITE 205
CHAMPAIGN, IL 61820-7050
Phone number: 217-352-9206
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Mailing Address
Dr. JEAN A BENACKER PhD
1701 S PROSPECT AVE SUITE 205
CHAMPAIGN, IL 61820-7050
Phone number: 217-352-9206
Copy
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