John S Banas, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036-081701 Issued in IL

Practice address

2570 24TH St
Suite 122
Rock Island, IL 61201-5394

Phone

(309) 779-3868

Fax

(309) 779-3139

NPI assigned

Aug 23, 2005

Reactivated

Apr 3, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1114910353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 24TH ST",
            "address_2": "STE. 122",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015394",
            "telephone_number": "309-779-3868",
            "fax_number": "309-779-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 24TH ST",
            "address_2": "SUITE 122",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015394",
            "telephone_number": "309-779-3868",
            "fax_number": "309-779-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANAS",
        "first_name": "JOHN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2012-05-21",
        "deactivation_date": "2006-03-27",
        "reactivation_date": "2006-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-081701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114910353",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0922052",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036081701",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Josie Bahen
• Katie Ann Baker, RN
• Melissa Baker, MS, CCC-SLP
• Jonathan E Baldwin, PA-C
• Derek A Ball, PHD
• Chad H Barclay, D.C.
• Logan Michael Barkley, PA-C
• Victor J Barney, MD
• Michael Barr, MD
• Kim R Barry

• Obstetrics & Gynecology Physician in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.