Provider Demographics
NPI:1306881768
Name:BANAS, ANNA K (MD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:K
Last Name:BANAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6033 W IRVING PARK RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-2521
Mailing Address - Country:US
Mailing Address - Phone:773-777-4767
Mailing Address - Fax:773-777-0328
Practice Address - Street 1:6033 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-2521
Practice Address - Country:US
Practice Address - Phone:773-777-4767
Practice Address - Fax:773-777-0328
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036087494208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2232882OtherBCBS
IL036087494Medicaid
IL036087494Medicaid
ILK27029Medicare PIN