NPIMap

Organization Active NPI

Diana M. Burda, MD SC

  • Internal Medicine Physician
  • Homer Glen, IL
National Provider Identifier
1194740613
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036080974 Issued in IL
Legal business name
DIANA M. BURDA, MD SC
Practice address
15929 S Bell Rd
Homer Glen, IL 60491-6707
Phone
(708) 745-5600
Fax
(708) 745-5268
NPI assigned
Jul 13, 2006
Last updated
Apr 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Authorized official

Name
Diana M Burda, MDNPI 1083631543
Title
Owner/Physician
Phone
(708) 745-5600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036080974 IL Primary

Addresses

Primary practice location

15929 S Bell Rd
Homer Glen, IL 60491-6707

Mailing address

12626 Lakeview Dr
Orland Park, IL 60467
Phone (708) 301-7924

Other identifiers 1

IdentifierTypeStateIssuer
036080974MedicaidIL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1194740613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12626 LAKEVIEW DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "60467",
            "telephone_number": "708-301-7924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15929 S BELL RD",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604916707",
            "telephone_number": "708-745-5600",
            "fax_number": "708-745-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANA M. BURDA, MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "BURDA",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "708-745-5600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036080974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036080974",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer Glen, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.