MEDICARE: DR. ELEANOR RESANE BANZON 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
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	C1-0010468	DE
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	036.139820	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01257423	OTHER	DE	RAIL ROAD MEDICARE

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104123546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELEANOR RESANE BANZON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 820
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-0820
Country	:	US
Telephone Number	:	917-397-0555
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 E 51ST ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-2400
Country	:	US
Telephone Number	:	312-572-2000
Fax Number	:

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

Provider Enumeration Date	:	02/22/2011
Last Update Date	:	01/13/2026

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Directions to “ DR. ELEANOR RESANE BANZON M.D.” Practice Location

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