Organization
ASB MEDICAL CLINIC, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNA K BANAS MD (PRESIDENT)
(773) 777-4767
Entity
Organization
Contact information
Practice address
6033 W IRVING PARK RD, CHICAGO, IL 60634-2521
(773) 777-4767
(773) 777-0328
Mailing address
6033 W IRVING PARK RD, CHICAGO, IL 60634-2521
(773) 777-4767
(773) 777-0328
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
36087494
IL
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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