Organization Active NPI

Rebecca J Duke MD PC

  • Specialist
  • Chicago, IL
National Provider Identifier
1316279441
Registry record updated Jan 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036079316 Issued in IL
Legal business name
REBECCA J DUKE MD PC
Practice address
3929 N Central Ave
Ste 3
Chicago, IL 60634-3072
Phone
(773) 202-7703
Fax
(773) 202-7708
NPI assigned
Jan 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2010

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

Authorized official

Name
Rebecca J Duke, M.D.
Title
President
Phone
(773) 202-7703

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 036079316 IL Primary

Addresses

Primary practice location

3929 N Central Ave
Ste 3
Chicago, IL 60634-3072

Mailing address

3929 N Central Ave
Ste 3
Chicago, IL 60634-3072
Phone (773) 202-7703

Other identifiers 1

IdentifierTypeStateIssuer
036079316MedicaidIL

National Provider Directory

National Provider Directory

Locations

3929 N Central Ave
Ste 3
Chicago, IL 60634
Phone (773) 202-7703

NPI Registry JSON

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264723200000",
    "number": "1316279441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929 N CENTRAL AVE",
            "address_2": "STE 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606343072",
            "telephone_number": "773-202-7703",
            "fax_number": "773-202-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3929 N CENTRAL AVE",
            "address_2": "STE 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606343072",
            "telephone_number": "773-202-7703",
            "fax_number": "773-202-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBECCA J DUKE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-29",
        "last_updated": "2010-01-29",
        "status": "A",
        "authorized_official_last_name": "DUKE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-202-7703",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036079316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036079316",
            "state": "IL"
        }
    ],
    "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 Jan 29, 2010; 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.