Individual
DR. ANTONI BANAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19 HERITAGE DR, STE 209, BOURBONNAIS, IL 60914-1369
(815) 932-3540
(815) 932-3611
Mailing address
19 HERITAGE DR, STE 209, BOURBONNAIS, IL 60914-1369
(815) 932-3540
(815) 932-3611
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036090701
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036090701
—
IL
05
—
651282261
—
IL
Enumeration date
10/17/2006
Last updated
09/13/2011
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