DR. BENJAMIN DANIEL CHILCZUK (NPI# 1831160886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831160886 |
| Entity Type | Individual |
| Full Name | DR. BENJAMIN DANIEL CHILCZUK |
| Credential | MD |
| Practice Address |
4011 Talbot Rd S Suite 300 Renton WA 98055-5773 |
| Mailing Address |
805 Madison St Suite 901 Seattle WA 98104-1172 |
| Practice Telephone | 4256565060 |
| Practice Fax Number | 4256565047 |
| Mailing Telephone | 2062648100 |
| Mailing Fax Number | 2062648689 |
| Enumeration Date | 2006-01-29 |
| Last Update Date | 2011-10-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
MD00021945 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
4011 TALBOT RD S SUITE 300 |
| City | RENTON |
| State | WA |
| Zip Code | 98055-5773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528061694 | Guy V Buell | Specialist | 4011 Talbot Rd S, Ste 440, Renton, WA 98055-5791 | 2005-05-23 |
| 1649756883 | Amy Elizabeth Hardiman | Physical Therapy Assistant | 4011 Talbot Rd S, Renton, WA 98055-5773 | 2018-07-11 |
| 1336665959 | Mary Elizabeth Walton | Dietitian, Registered | 4011 Talbot Rd S, Renton, WA 98055-5773 | 2017-08-15 |
| 1548791924 | Southlake Select, PC | Point of Service | 4011 Talbot Rd S, 440, Renton, WA 98055-5773 | 2017-03-27 |
| 1871031864 | Abrey Lee | Dietitian, Registered | 4011 Talbot Rd S, Suite 100, Renton, WA 98055-5773 | 2017-02-09 |
| 1962940957 | Kimberly Diana Konczak | Dietitian, Registered | 4011 Talbot Rd S, Suite 100, Renton, WA 98055-5773 | 2017-02-09 |
| 1578931325 | Andrew S Huntley | Physician Assistant | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2015-09-10 |
| 1285011080 | Anne Macleod | Registered Nurse | 4011 Talbot Rd S, Renton, WA 98055-5773 | 2015-04-30 |
| 1508263716 | Mie Hagiwara | Physician Assistant | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2014-12-03 |
| 1073921813 | Zachary A. Bowman | Physician Assistant | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2014-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965750 | Proliance Surgery Center At Valley, LLC | Clinic/Center | 4009 Talbot Road S, Suite 200, Renton, WA 98055 | 2020-06-01 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1154878668 | Nelson Family Dentistry | Dentist | 19221 108th Ave Se Suite #2, Renton, WA 98055 | 2016-09-01 |
| 1598182990 | Annie Kyunga Ahn | Otolaryngology | 4033 Talbot Rd S Ste 540, Renton, WA 98055 | 2014-03-24 |
| 1376960138 | Madhuri Gordhan Patel | Registered Nurse | 3501 Mill Place South, Renton, WA 98055 | 2014-03-18 |
| 1912331042 | Karen Dohr | Pharmacist | 400 S. 43 Street, Renton, WA 98055 | 2013-08-26 |
| 1659637668 | Benjamin Reiss | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055 | 2012-04-03 |
| 1205137940 | Duy Ai Quang Hoang | Pharmacist | 9431 S 196th Pl, Renton, WA 98055 | 2010-11-11 |
| 1972823664 | Erica L Ellzey | Physical Therapist | 18623 112th Ave Se, Renton, WA 98055 | 2010-06-04 |
| 1588984587 | Melissa A. Jordan | Nurse Anesthetist, Certified Registered | 4011 Talbot Rd., 5th Floor, Renton, WA 98055 | 2010-06-02 |
| Find all providers in zip 98055 | ||||
| Taxonomy Code | 2083P0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Preventive Medicine/Occupational Environmental Medicine |
| A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962473918 | Michael Douglas Allison | Preventive Medicine | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2006-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003276411 | Workwell Consultants, LLC | Preventive Medicine | 818 W Riverside Ave Ste 100, Spokane, WA 99201-0910 | 2016-02-26 |
| 1336481183 | Srivani Kanumuri | Preventive Medicine | 16690 Redmond Way Ste C, Redmond, WA 98052-4434 | 2013-03-20 |
| 1720323116 | Morley Slutsky | Preventive Medicine | 4580 Klahanie Dr. S.e.,#125, Issaquah, WA 98029 | 2012-12-11 |
| 1932358744 | Ann Tu | Preventive Medicine | Oem Program, 325 9th Ave, Box 359739, University of Washington, Seattle, WA 98104 | 2008-09-17 |
| 1447370879 | Indrek Melder | Preventive Medicine | 1979 Snyder St Ste 150, Richland, WA 99354-5321 | 2007-03-30 |
| 1366509259 | Clyde H. Wilson | Preventive Medicine | 3223 1st Avenue South, Suite C, Seattle, WA 98134 | 2007-01-02 |
| 1831262260 | Steven Michael Hall | Preventive Medicine | 120 1st Ave Nw, Issaquah, WA 98027-3228 | 2006-11-15 |
| 1811954092 | Douglas Fredrick Phillip | Preventive Medicine | 30042 12th Ln Sw, Federal Way, WA 98023-3448 | 2006-04-30 |
| 1366408353 | Paul S Darby | Preventive Medicine | 1930 Port of Tacoma Rd., Franciscan Occupational Health, Tacoma, WA 98421 | 2006-04-26 |
| 1841270311 | U.S. Healthworks Medical Group of Arkansas, Inc. | Preventive Medicine | 1100 Virginia St, Suite 215, Seattle, WA 98101-1439 | 2006-01-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. BENJAMIN DANIEL CHILCZUK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.