MEDICARE: DR. VINCENT F BIANK 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	208000000X	Pediatrics Physician	036129342	IL
2	2080T0004X	Pediatric Transplant Hepatology Physician	036129342	IL
3	2080P0206X	Pediatric Gastroenterology Physician	036129342	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000017615K	OTHER		HUMANA

General Provider Information

NPI Number	:	1811948243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINCENT F BIANK MD

Provider Business Mailing Address
First Line	:	1000 CENTRAL ST STE HOSPITAL
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1777
Country	:	US
Telephone Number	:	847-570-1795
Fax Number	:	847-503-4590

Provider Business Practice Location Address
First Line	:	1000 CENTRAL ST STE 800
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1780
Country	:	US
Telephone Number	:	847-570-1795
Fax Number	:	847-503-4590

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	05/19/2022

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Directions to “ DR. VINCENT F BIANK MD” Practice Location

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