Provider Demographics
NPI:1083828156
Name:BANKS, PAULA JS (MED, DT)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:JS
Last Name:BANKS
Suffix:
Gender:F
Credentials:MED, DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17W464 EARL CT
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-5108
Mailing Address - Country:US
Mailing Address - Phone:630-960-5166
Mailing Address - Fax:630-960-5166
Practice Address - Street 1:17W464 EARL CT
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-5108
Practice Address - Country:US
Practice Address - Phone:630-960-5166
Practice Address - Fax:630-960-5166
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist