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Contact Information

KAREN J BANDUSCH HARRIS, PA-C
405 KAYS DRIVE
NORMAL, IL61761
 Phone: 309-862-0064
 Fax: 309-862-1542
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for KAREN J BANDUSCH HARRIS · (Female)

NPI Number 1003994104
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 11/02/2006
Last updated 01/15/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 085 000712
  • IL License # 085-000712
  • IL Medicaid 588330
  • Other 5723204 BCBS
  • Other 084278 HEALTH ALLIANCE
  • Other 588330 OSF HEALTH PLAN CP
  • Other CK5970 RR MEDIC
Hospital affiliation(s) Not Available
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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