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Organization

BANDYK PODIATRY

Active
Other names
Bandyk Podiatry
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT JON BANDYK (DR)
(708) 474-1900
Entity
Organization

Contact information

Practice address
18503 TORRENCE AVE, LANSING, IL 60438
(708) 474-1900
(708) 474-1037
Mailing address
18503 TORRENCE AVE, LANSING, IL 60438
(708) 474-1900
(708) 474-1037

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016-004010
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016004010
IL
01
4800148821
RAILROAD MEDICARE
01
6000 1 555
BLUECROSS BLUESHIELD
IL
Enumeration date
03/31/2008
Last updated
06/11/2008
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