Banio P Koroma, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

036-069938 Issued in IL

Practice address

3319 N Elston Ave
Suite 100
Chicago, IL 60618-5811

Phone

(773) 751-7200

Fax

(773) 583-4295

NPI assigned

Jun 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

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 and National Provider Directory roles.

• Docs at the Door Inc

  • In Home Supportive Care Agency
  • Matteson, IL
  • NPI 1346576055
  NPD (past)
• Lake Mi Mobile Doctors, P.C.

  • Primary Podiatric Medicine Podiatrist
  • Chicago, IL
  • NPI 1992870281
  NPD (past)
• Lake Mi Mobile Doctors P.C.

  • Geriatric Medicine (Internal Medicine) Physician
  • Austin, TX
  • NPI 1982962924

  Geriatric Medicine

  NPD (past)
• Lake Mi Mobile Doctors, P.C.

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Louis, MO
  • NPI 1992057566

  Geriatric Medicine

  NPD (past)
• Mobile Ultrasound LLC

  • Vascular Specialist/Technologist Cardiovascular
  • Kansas City, MO
  • NPI 1407113517
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367971200000",
    "number": "1962443739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3319 N ELSTON AVE",
            "address_2": "SUITE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185811",
            "telephone_number": "773-751-7200",
            "fax_number": "773-583-4295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 N ELSTON AVE",
            "address_2": "SUITE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185811",
            "telephone_number": "773-751-7200",
            "fax_number": "773-583-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROMA",
        "first_name": "BANIO",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2013-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036-069938",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036-069938",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IN",
            "license": "01048271A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarena Arlene Korni, LCPC
• Lisa M Kornita, DPT
• Victoria Alexandra Korol, DMD
• Jamie Ann Korolyov, D.M.D.
• Mikhail Korolyov, D.M.D.
• Michael James Koronkowski, PHARM.D.
• Michalina Christina Koronkowski
• Jenifer Corinne Korotko, LCPC
• Kirill Korotkov
• Sophia Korovaichuk, MD

• All providers in Chicago, IL
• Geriatric Medicine (Internal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.