Individual
DR. ISIS M DURAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 283-5500
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036123529
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
036123529
IL
2084N0400X
Neurology Physician
036123529
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036123529
STATE LICENSE
IL
05
—
036123529
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147067
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
P00974077
MEDICARE RAILROAD PTAN
IL
Enumeration date
09/04/2008
Last updated
10/23/2024
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