Individual
BANIO P KOROMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3319 N ELSTON AVE, SUITE 100, CHICAGO, IL 60618-5811
(773) 751-7200
(773) 583-4295
Mailing address
3319 N ELSTON AVE, SUITE 100, CHICAGO, IL 60618-5811
(773) 751-7200
(773) 583-4295
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
036-069938
IL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
01048271A
IN
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036-069938
IL
Other
Enumeration date
06/10/2006
Last updated
05/08/2013
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