Individual
TERRILL M BANER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 JOHN DEERE RD, SUITE 400, MOLINE, IL 61265-6869
(309) 779-4600
(309) 779-4605
Mailing address
600 JOHN DEERE RD, SUITE 400, MOLINE, IL 61265-6869
(309) 779-4600
(309) 779-4605
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036058643
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036058643
—
IL
01
—
08100333
BLUE CROSS BLUE SHIELD
IL
05
—
1245201714
—
IA
01
—
IL0101
JOHN DEERE INSURANCE
IL
Enumeration date
01/31/2006
Last updated
01/15/2014
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