Individual
DR. PRIYA J BANSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.,
Contact information
Practice address
2435 DEAN ST UNIT C, SAINT CHARLES, IL 60175-4827
(630) 584-6127
(630) 584-6070
Mailing address
1187 CLEANDER CT, NAPERVILLE, IL 60540-7352
(630) 247-4304
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
036103919
IL
207KA0200X
Allergy Physician
036103919
IL
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
036103919
IL
2080P0201X
Pediatric Allergy/Immunology Physician
036103919
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036103919
—
IL
Enumeration date
11/28/2005
Last updated
02/20/2023
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