MR. JOHN D BENTON (LCSW) – Clinical Social Worker, NPI 1639358039

MR. JOHN D BENTON (LCSW) is a healthcare provider. based in Rockford, Illinois. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 149.012605 (IL). The NPI Number for MR. JOHN D BENTON (LCSW) is 1639358039

Main info

Male
Sole Proprietor
21 Years Of Experience
Accepts Medicare Assignment
Name
MR. JOHN D BENTON (LCSW)
NPI
1639358039
Phone
(815) 968-9300
Address
526 W STATE ST
Enumeration Date
1 November 2007
Last Update Date
4 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8006931916
Graduation Year
2005 (21 years ago)
PAC ID
3072679729
Group Practice PAC ID
4880768415
Professional Enrollment ID
I20090304000235
Address ID
IL601735855SC1051XDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:18State licenses:1Digital endpointsOther names

3,510 CLINICAL SOCIAL WORKER in IL

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Provider Addresses for MR. JOHN D BENTON (LCSW)

  • 526, West State Street, Rockford, Winnebago County, Illinois, 61101, United States

    ROCKFORD, IL 611011214

    Phone: (815) 968-9300

    Fax: (815) 968-5314

    Type: Mailing

  • 9308 BALDWIN DR

    MACHESNEY PARK, IL 611151720

    Phone: (779) 537-4631

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-03-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090304000235IClinical Social WorkerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61101)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4880768415View full group profile
NameSpecialtyState
-MI
Clinical Social WorkerMI
-IN
Clinical Social WorkerMI
Clinical PsychologistMI
Clinical Social WorkerWI
Clinical Social WorkerMI
-MI
Clinical Social WorkerMI
Clinical Psychologist, Mental Health CounselorIL

Reviews

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Frequently asked questions

How do I look up MR. JOHN D BENTON (LCSW) by NPI?
Use NPI 1639358039 when you need to reference MR. JOHN D BENTON (LCSW) in forms, claims, or directories.
Is MR. JOHN D BENTON (LCSW) currently active in the NPI registry?
CMS-published data lists MR. JOHN D BENTON (LCSW) as an active registrant.
What kind of provider is MR. JOHN D BENTON (LCSW)?
The page reflects Clinical Social Worker for MR. JOHN D BENTON (LCSW). Clinical services aligned with this taxonomy classification.
Where does public data place MR. JOHN D BENTON (LCSW)?
The snapshot lists Rockford, Illinois for MR. JOHN D BENTON (LCSW); download NPPES for the complete set.
Is MR. JOHN D BENTON (LCSW) a real provider?
This page reflects official NPPES data for NPI 1639358039. Always confirm identity and privileges with the practice and licensing boards.

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