Individual ProviderBenjamin BennettSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address1812 W Cortland St Apt 3f, Chicago, IL 60622-1062(615) 785-6442PECOS EnrollmentBased on the most recent information from CMS, provider Benjamin Bennett does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1467824003Provider TypeIndividualFull NameBennett, BenjaminCredentialCCC-SLPGenderMaleSole ProprietorYesEnumeration Date10/22/2015Last Updated10/22/2015Contact InformationPractice LocationPractice Address1812 W Cortland St Apt 3f, Chicago, IL 60622-1062Phone(615) 785-6442FaxUnlisted FaxMailing LocationMailing Address1812 W Cortland St Apt 3f, Chicago, IL 60622-1062Phone(615) 785-6442FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense146011444Illinois