NPIMap

Organization Active NPI

Antoni Banas Inc

  • Pediatrics Physician
  • Bourbonnais, IL
National Provider Identifier
1790053940
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036090701 Issued in IL
Legal business name
ANTONI BANAS INC
Practice address
19 Heritage Dr Ste 209
Bourbonnais, IL 60914-1369
Phone
(815) 932-3540
Fax
(815) 932-3611
NPI assigned
Dec 2, 2011
Last updated
Apr 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Authorized official

Name
Dr. Antoni Banas, M.D.NPI 1730269408
Title
Physician
Phone
(815) 932-3540

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036090701 IL Primary

Addresses

Primary practice location

19 Heritage Dr Ste 209
Bourbonnais, IL 60914-1369

Mailing address

19 Heritage Dr Ste 209
Bourbonnais, IL 60914-1369
Phone (815) 932-3540

National Provider Directory

National Provider Directory

Locations

19 Heritage Dr
Ste 209
Bourbonnais, IL 60914
Phone (815) 932-3540

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1790053940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 HERITAGE DR 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 STE 209",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141369",
            "telephone_number": "815-932-3540",
            "fax_number": "815-932-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTONI BANAS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-02",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "BANAS",
        "authorized_official_first_name": "ANTONI",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "815-932-3540",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036090701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; 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.