Individual
DR. THEODORE BANKS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050
(815) 338-6600
Mailing address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050-8409
(815) 338-6600
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01049408A
IN
207P00000X
Emergency Medicine Physician
Primary
036123608
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01049408A
INDIANA LICENSE
IN
01
—
01049408B
CSR
IN
01
—
036123608
STATE LICENSE
IL
05
—
200197460
—
IN
Enumeration date
06/03/2006
Last updated
03/07/2023
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