Active NPI
John Robert Durburg
- Psychiatry Physician
- Highland Park, IL
National Provider Identifier
1497027320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036039877
- Practice address
- 3535 Patten Rd Apt 1E
Highland Park, IL 60035-5957 - Phone
- (847) 433-4373
- Fax
- (847) 433-4373
- NPI assigned
- Feb 8, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036039877 | IL | Primary |
Addresses
Primary practice location
3535 Patten Rd Apt 1E
Highland Park, IL 60035-5957
Mailing address
3535 Patten Rd Apt 1E
Highland Park, IL 60035-5957
Phone (847) 433-4373
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036039877 | IL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328659200000",
"number": "1497027320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3535 PATTEN RD APT 1E",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600355957",
"telephone_number": "847-433-4373",
"fax_number": "847-433-4373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3535 PATTEN RD APT 1E",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600355957",
"telephone_number": "847-433-4373",
"fax_number": "847-433-4373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURBURG",
"first_name": "JOHN",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-08",
"last_updated": "2012-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036039877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.