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Contact Information

GEORGE A BANUELOS, MD
3540 SEVEN BRIDGES DR STE 200
WOODRIDGE, IL60517
 Phone: 630-810-0777
 Fax: 630-810-0395
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for GEORGE A BANUELOS · (Male)

NPI Number 1396815601
Status Active
Credentials MD
Entity Individual
Enumeration date 11/08/2006
Last updated 12/20/2021 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036070501
  • IL Medicaid 036070501
  • IL Other 2201686 BCBS IL
  • IL Other 036070501 STATE LICENSE NUMBER
Hospital affiliation(s)
  • COPLEY MEMORIAL HOSPITAL - (Acute Care)
    2000 OGDEN AVENUE
    AURORA, IL 60504
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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