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NPI Code Detail

MEDICARE: JANE BANG M.D.

MEDICARE:   JANE  BANG  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician036113330IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101623792OTHERILBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588740955
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE BANG M.D.
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number : 847-390-5900
Fax Number :
Provider Business Practice Location Address
First Line : 1435 W WEBSTER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-3049
Country : US
Telephone Number : 773-880-0320
Fax Number : 312-204-5501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2006
Last Update Date : 02/19/2026

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