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Organization
BANDYK PODIATRY
Active
Organization
BANDYK PODIATRY
Active
Other names
Bandyk Podiatry
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT JON BANDYK (DR)
(708) 474-1900
Entity
Organization
Contact information
Practice address
18503 TORRENCE AVE, LANSING, IL 60438
(708) 474-1900
(708) 474-1037
Mailing address
18503 TORRENCE AVE, LANSING, IL 60438
(708) 474-1900
(708) 474-1037
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016-004010
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004010
—
IL
01
—
4800148821
RAILROAD MEDICARE
—
01
—
6000 1 555
BLUECROSS BLUESHIELD
IL
Enumeration date
03/31/2008
Last updated
06/11/2008
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