Banks, Theodore

Banks, Theodore is an individual health care provider with primary practice located at 4201 W Medical Center Dr , Mchenry IL 60050. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Banks, Theodore can be contacted via phone (815) 338-6600.

Contact Information

Primary practice address
4201 W Medical Center Dr Mchenry IL 60050
Phone: (815) 338-6600
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 01049408A Indiana
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036123608 Illinois

Profile Details

NPI number 1790723500
LBN Legal business name Banks, Theodore
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2006
Last updated Mar 7th, 2023 - about last year

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 1790723500 NPPES
Indiana Other 01049408A INDIANA LICENSE
Indiana MEDICAID 200197460 INDIANA LICENSE
Indiana Other 036123608 INDIANA LICENSE
Indiana Other 01049408B INDIANA LICENSE

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