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Dr. Benedict Ikeudenta III, MD
Student in an Organized Health Care Education/Training Program in Loves Park, Illinois
NPI 1477256931

Benedict Ikeudenta III is a Student in an Organized Health Care Education/Training Program based in Rockford, IL. Benedict Ikeudenta III practices in Loves Park, IL and has the professional credentials of MD. The NPI Number for Benedict Ikeudenta III is 1477256931 and holds a License No. (Illinois).

The current practice location address for Benedict Ikeudenta III is 7702 N Alpine Rd, Loves Park, IL and can be reached out via phone at 815-971-3310.

Location: 7702 N Alpine Rd, Loves Park, IL, 61114-6663
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1477256931
Provider Name
Benedict Ikeudenta III
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
7702 N Alpine Rd, Loves Park, IL, 61114-6663
Phone Number
815-971-3310
Fax Number
Provider Enumeration Date
03/23/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
7702 N Alpine Rd
City
Loves Park
State
Illinois
Zip
61111-3107
Phone Number
815-971-3310
Fax Number
person
Provider Business Mailing Address Details
Address
7702 N Alpine Rd
City
Loves Park
State
Illinois
Zip
61111-3107
Phone Number
815-971-3310
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(Illinois)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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