Individual provider Active NPI

Mark Vincent Duerinck, MD

  • Interventional Cardiology Physician
  • Naperville, IL
National Provider Identifier
1689612681
Registry record updated Jul 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
036070721 Issued in IL
Practice address
801 S Washington St
4TH Floor
Naperville, IL 60540-7430
Phone
(630) 527-2730
NPI assigned
Jun 2, 2006
Last updated
Jul 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 036070721 IL Primary

Addresses

Primary practice location

801 S Washington St
4TH Floor
Naperville, IL 60540-7430

Mailing address

1919 S Highland Ave
Suite B202 Attn Jan Lewis
Lombard, IL 60148-6153
Phone (630) 268-1102

Other identifiers 2

IdentifierTypeStateIssuer
036070721MedicaidIL
060062540OtherRAILROAD MEDICARE

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

Practice roles

OrganizationSpecialtyStatusNew patients
Elmhurst Memorial Hospital Current Accepting new patients
Midwest Heart Specialists, LTD Interventional Cardiology Past Accepting new patients
Edward Cardiovascular Institute Past Accepting new patients
Edward Cardiovascular Institute Past Accepting new patients

Locations

Carol Stream, IL 60122

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216598400000",
    "number": "1689612681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 S HIGHLAND AVE",
            "address_2": "SUITE B202 ATTN JAN LEWIS",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486153",
            "telephone_number": "630-268-1102",
            "fax_number": "630-268-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S WASHINGTON ST",
            "address_2": "4TH FLOOR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605407430",
            "telephone_number": "630-527-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUERINCK",
        "first_name": "MARK",
        "middle_name": "VINCENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2008-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036070721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036070721",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060062540",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; 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.