Individual
AMY DURAKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
747 N RUTLEDGE ST FL 4, SPRINGFIELD, IL 62702-6700
(217) 545-8000
(217) 545-7877
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-8000
(217) 545-2101
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
209-012663
IL
363L00000X
Nurse Practitioner
209012663
IL
363LA2100X
Acute Care Nurse Practitioner
209012663
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209012663
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01534355
RAILROAD
IL
Enumeration date
03/27/2015
Last updated
10/23/2023
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