| Organization Name: | ASB MEDICAL CLINIC, LTD |
| NPI Number: | 1518308600 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANNA K BANAS (PRESIDENT) |
| Mailing Address: | 6033 W Irving Park Rd Chicago |
| State: | IL US |
| Postal Code: | 606342521 |
| Phone Number: | 7737774767 |
| Fax Number: | 7737770328 |
| NPI Enumeration Date: | 07/17/2013 |
| NPI Last Update Date: | 07/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 36087494 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |