MEDICARE: DR. MICHAEL C BANKER MD

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
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	0101238100	VA
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	167314	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033157169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL C BANKER MD

Provider Business Mailing Address
First Line	:	PO BOX 32
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60065-0032
Country	:	US
Telephone Number	:	847-593-8460
Fax Number	:	847-919-4615

Provider Business Practice Location Address
First Line	:	2965 OCEAN PKWY STE 200
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-8014
Country	:	US
Telephone Number	:	718-280-5573
Fax Number	:	718-301-1099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	10/12/2018

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Directions to “ DR. MICHAEL C BANKER MD” Practice Location

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