Individual provider Active NPI

Christina D Durbin, DC

  • Chiropractor
  • East Peoria, IL
National Provider Identifier
1154486983
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-008925 Issued in IL
Practice address
350 Cimmeron Dr
East Peoria, IL 61611-7511
Phone
(309) 688-4484
Fax
(309) 688-4485
NPI assigned
Dec 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-008925 IL Primary

Addresses

Primary practice location

350 Cimmeron Dr
East Peoria, IL 61611-7511

Mailing address

350 Cimmeron Dr
East Peoria, IL 61611-7511
Phone (309) 688-4484

Other identifiers 4

IdentifierTypeStateIssuer
200489777OtherILADVANCED PHYSICIAN HEALTH CARE TAX ID
1154486983OtherILINDIVIDUAL NPI CHRISTY DURBIN
1568658409OtherILGROUP NPI
461198344OtherILSYNERGY TAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071130000570 IL Practitioner - Chiropractic 7517056393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

350 Cimmeron Dr
East Peoria, IL 61611-7511
Phone (309) 688-4484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-008925ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Healthcare Physical Medicine SC Chiropractor Current Accepting new patients
Synergy Healthcare Physical Medicine Current Accepting new patients

Locations

350 Cimmeron Dr
East Peoria, IL 61611
Phone (309) 688-4484

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1154486983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 CIMMERON DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616117511",
            "telephone_number": "309-688-4484",
            "fax_number": "309-688-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 CIMMERON DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616117511",
            "telephone_number": "309-688-4484",
            "fax_number": "309-688-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURBIN",
        "first_name": "CHRISTINA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-008925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PHYSICIAN HEALTH CARE TAX ID",
            "identifier": "200489777",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL  NPI CHRISTY DURBIN",
            "identifier": "1154486983",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1568658409",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SYNERGY TAX ID",
            "identifier": "461198344",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.