Active NPI
Stacey Ellen Ban, MD
- Hematology & Oncology Physician
- Skokie, IL
National Provider Identifier
1154334159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- 036108968
- Practice address
- 9631 Gross Point Rd
Ste 10
Skokie, IL 60076-1264 - Phone
- (847) 675-3900
- Fax
- (847) 675-3930
- NPI assigned
- Aug 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | 036108968 | IL | Primary |
Addresses
Primary practice location
9631 Gross Point Rd
Ste 10
Skokie, IL 60076-1264
Mailing address
9631 Gross Point Rd
Ste 10
Skokie, IL 60076-1264
Phone (847) 675-3900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036108968 | Other | IL | STATE LICENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036108968 | IL | MD | Hematology & Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290556800000",
"number": "1154334159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9631 GROSS POINT RD",
"address_2": "STE 10",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600761264",
"telephone_number": "847-675-3900",
"fax_number": "847-675-3930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9631 GROSS POINT RD",
"address_2": "STE 10",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600761264",
"telephone_number": "847-675-3900",
"fax_number": "847-675-3930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAN",
"first_name": "STACEY",
"middle_name": "ELLEN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2010-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "IL",
"license": "036108968",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENCE",
"identifier": "036108968",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Skokie, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.