Provider Demographics
NPI:1750574901
Name:BANAS, SANDRA L K (MD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:L K
Last Name:BANAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 713260
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1260
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:630-420-8822
Practice Address - Street 1:24600 W 127TH ST STE 130
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-9507
Practice Address - Country:US
Practice Address - Phone:815-416-6800
Practice Address - Fax:630-420-8877
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2023-08-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036121942207Y00000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology