Bandera, Robert M

Bandera, Robert M is an individual health care provider with primary practice located at 1301 S. Kiwanis Dr. , Freeport IL 61032. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bandera, Robert M can be contacted via phone (815) 235-1406.

Contact Information

Primary practice address
1301 S. Kiwanis Dr. Freeport IL 61032
Phone: (815) 235-1406
Fax: (815) 732-3718
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-106029 Illinois

Profile Details

NPI number 1134199458
LBN Legal business name Bandera, Robert M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2006
Last updated Dec 16th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134199458 NPPES
Illinois MEDICAID 036106029

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