Provider Demographics
NPI:1023265337
Name:VANCURA, BENJAMIN GLENN (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:GLENN
Last Name:VANCURA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1941 ROHLWING RD
Mailing Address - Street 2:
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-1338
Mailing Address - Country:US
Mailing Address - Phone:847-725-8640
Mailing Address - Fax:847-618-0859
Practice Address - Street 1:1941 ROHLWING RD
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-1338
Practice Address - Country:US
Practice Address - Phone:847-725-8640
Practice Address - Fax:847-618-0859
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-124182207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology