Individual
ROBERT A BANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 S 1ST ST, CHAMPAIGN, IL 61820-7661
(217) 383-9400
Mailing address
611 W. PARK ST., FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
036110097
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0533210001
DMERC
IL
01
—
P00109532
RAILROAD
IL
Enumeration date
07/10/2006
Last updated
01/29/2020
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