Khalid Talal Bannan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

125.056746 Issued in IL

Practice address

4646 North Marine Drive
Chicago, IL 60640

Phone

(773) 564-5225

Fax

(773) 564-5226

NPI assigned

Aug 10, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249862400000",
    "number": "1699907659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E ONTARIO ST APT 2501B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114879",
            "telephone_number": "215-327-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 NORTH MARINE DRIVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60640",
            "telephone_number": "773-564-5225",
            "fax_number": "773-564-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNAN",
        "first_name": "KHALID",
        "middle_name": "TALAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-10",
        "last_updated": "2009-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.056746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Racheal J Banks, COTA/L
• Typhannie Patrice Banks
• Willie Banks, GED
• Lindsay Banman
• Christopher Banna, O.D.
• Besan Maher Bannasch
• Jasmine Banner - Hubbard, LCPC
• Carolyn Sehlbrede Banner, RD, LDN
• David James Banner, MD, PHD
• Haasan Prince Eli Banner, MD

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; 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.