Andrew Quinby Defuniak, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-107970 Issued in IL

Practice address

2800 S California Ave
Med/Surg Office
Chicago, IL 60608-5107

Phone

(773) 869-7488

Fax

(773) 869-3578

NPI assigned

Oct 4, 2006

Last updated

Apr 22, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: adefuniak@direct.ccprovider.org

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1508951351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5245 N MAGNOLIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402202",
            "telephone_number": "773-869-7488",
            "fax_number": "773-869-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 S CALIFORNIA AVE",
            "address_2": "MED/SURG OFFICE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606085107",
            "telephone_number": "773-869-7488",
            "fax_number": "773-869-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFUNIAK",
        "first_name": "ANDREW",
        "middle_name": "QUINBY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-107970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ADeFuniak@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Regina Therese Defranco
• Megan A Defrates
• Antoinette M Defrenza, PHARMD
• Grace Dianne Defrino, APRN
• Paul F Defrino, MD
• Katherine Degaetano, ATC
• Katherine Daw Degayner, M.S., CCC-SLP
• Jill Degen
• Alexander Degenhard
• Russell Deghi

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.