Antoni Banas, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036090701 Issued in IL

Practice address

19 Heritage Dr
Ste 209
Bourbonnais, IL 60914-1369

Phone

(815) 932-3540

Fax

(815) 932-3611

NPI assigned

Oct 17, 2006

Last updated

Sep 13, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Antoni Banas Inc

  • Pediatrics Physician
  • Bourbonnais, IL
  • NPI 1790053940
  Authorized official Same address or phone
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1730269408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 HERITAGE DR",
            "address_2": "STE 209",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141369",
            "telephone_number": "815-932-3540",
            "fax_number": "815-932-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 HERITAGE DR",
            "address_2": "STE 209",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141369",
            "telephone_number": "815-932-3540",
            "fax_number": "815-932-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANAS",
        "first_name": "ANTONI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036090701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090701",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "651282261",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Naaz Fatima Aziz, M.D.
• Abosede R Babalola, PMHNP
• Faizan Bader
• Kristin Bailey, LCSW
• Regina E Baltimore Redeaux
• Linda Sue Barbee, MA LCPC NCC
• Marla J Barnard, LCPC
• Jaime Barnas, CPNP-BC
• Michael R Barnett, MSW-LCSW
• Andrew K Basham, D.C.

• Pediatrics Physician in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.