Individual provider Active NPI

Eugene P Durbin, M.D.

  • General Practice Physician
  • Chicago, IL
National Provider Identifier
1225019474
Registry record updated Feb 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
35-054602 Issued in OH
Practice address
75 Remittance Dr
Chicago, IL 60675-6508
Phone
(614) 442-2400
Fax
(614) 442-2403
NPI assigned
Nov 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 35-054602 OH Primary

Addresses

Primary practice location

75 Remittance Dr
Chicago, IL 60675-6508

Mailing address

110 N Poplar St
Oxford, OH 45056-1204
Phone (513) 523-2111

Other identifiers 1

IdentifierTypeStateIssuer
0867629MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-054602OHMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329091200000",
    "number": "1225019474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N POPLAR ST",
            "city": "OXFORD",
            "state": "OH",
            "postal_code": "450561204",
            "telephone_number": "513-523-2111",
            "fax_number": "513-524-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 REMITTANCE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606756508",
            "telephone_number": "614-442-2400",
            "fax_number": "614-442-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURBIN",
        "first_name": "EUGENE",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2012-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "35-054602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0867629",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.