Dr Theodore Banks Jr, MD | |
4201 W Medical Center Dr, Mchenry, IL 60050 | |
(815) 338-6600 | |
Not Available |
Full Name | Dr Theodore Banks Jr |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 4201 W Medical Center Dr, Mchenry, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1790723500 | NPI | - | NPPES |
01049408A | Other | IN | INDIANA LICENSE |
200197460 | Medicaid | IN | |
036123608 | Other | IL | STATE LICENSE |
01049408B | Other | IN | CSR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 01049408A (Indiana) | Secondary |
207P00000X | Emergency Medicine | 036123608 (Illinois) | Primary |
Entity Name | Northwestern Medical Faculty Foundation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346235314 PECOS PAC ID: 4587576814 Enrollment ID: O20031105000541 |
Mailing Address | Practice Location Address |
---|---|
Dr Theodore Banks Jr, MD 4201 W Medical Center Dr, Mchenry, IL 60050-8409 Ph: (815) 338-6600 | Dr Theodore Banks Jr, MD 4201 W Medical Center Dr, Mchenry, IL 60050 Ph: (815) 338-6600 |
Dr. Robert W Schwaner, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 3922 Mercy Dr, Mchenry, IL 60050 Phone: 815-344-4499 | |
Katherine Jean Savage, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 4201 W Medical Center Dr, Mchenry, IL 60050 Phone: 815-759-3100 Fax: 815-363-9094 | |
Dr. Leonard Levites, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 4201 W Medical Center Dr, Mchenry, IL 60050 Phone: 815-338-6600 | |
John Pacini, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 4201 W Medical Center Dr, Mchenry, IL 60050 Phone: 815-759-3100 Fax: 815-363-9044 | |
Aldo Giovanni Gonzalez, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 4201 W Medical Center Dr, Mchenry, IL 60050 Phone: 815-759-3100 Fax: 815-363-9094 | |
Dr. Anna Morse Loughlin, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 4201 W Medical Center Dr, Mchenry, IL 60050 Phone: 815-759-3100 | |
Neda Imam, M.D Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 4201 W Medical Center Dr, Mchenry, IL 60050 Phone: 815-759-4323 Fax: 815-759-4948 |