Individual
DR. STACEY ELLEN BAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9631 GROSS POINT RD, STE 10, SKOKIE, IL 60076-1264
(847) 675-3900
(847) 675-3930
Mailing address
9631 GROSS POINT RD, STE 10, SKOKIE, IL 60076-1264
(847) 675-3900
(847) 675-3930
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
036108968
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036108968
STATE LICENCE
IL
Enumeration date
08/14/2006
Last updated
11/24/2010
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