Individual ProviderBenjamin MbaInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1901 West Harrison St, John H.Stroger Jr. Hospital Of Cook County, Chicago, IL 60612(312) 864-6000(312) 864-7231PECOS EnrollmentBased on the most recent information from CMS, provider Benjamin Mba is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1356378749Provider TypeIndividualFull NameMba, BenjaminCredentialMDGenderMaleSole ProprietorNoEnumeration Date6/28/2006Last Updated5/4/2023Contact InformationPractice LocationPractice Address1901 West Harrison St, John H.Stroger Jr. Hospital Of Cook County, Chicago, IL 60612Phone(312) 864-6000FaxUnlisted FaxMailing LocationMailing Address1900 W Polk St, Room 1518, Chicago, IL 60612-3723Phone(312) 864-7231Fax(312) 864-9725Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense036-106690IllinoisCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense73827Connecticut