Provider Demographics
NPI:1275515827
Name:BAYANG, MARIA CHRISTINE N (MD)
Entity Type:Individual
Prefix:
First Name:MARIA CHRISTINE
Middle Name:N
Last Name:BAYANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 READ ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-3265
Mailing Address - Country:US
Mailing Address - Phone:815-838-7337
Mailing Address - Fax:815-838-5007
Practice Address - Street 1:300 READ ST
Practice Address - Street 2:SUITE A
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-3265
Practice Address - Country:US
Practice Address - Phone:815-838-7337
Practice Address - Fax:815-838-5007
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-093818208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-093818Medicaid