DR. Preston Allen Mercurius Banoub, DMD is a student in an organized health care education training program in Chicago, IL. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Preston Allen Mercurius Banoub, DMD NPI is 1578138376. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
1900 W POLK ST UNIT 611
CHICAGO, IL
ZIP 60612-723
Phone: (312) 864-0200
The NPI 1578138376 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).
The enumeration date for this NPI number is 5/24/2021 and was last updated on 5/24/2021.