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Individual

DR. JOHN S BANAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2570 24TH ST, SUITE 122, ROCK ISLAND, IL 61201-5394
(309) 779-3868
(309) 779-3139
Mailing address
2570 24TH ST, STE. 122, ROCK ISLAND, IL 61201-5394
(309) 779-3868
(309) 779-3199

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-081701
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036081701
IL
05
0922052
IA
05
1114910353
IL
Enumeration date
08/23/2005
Last updated
05/21/2012
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