Active NPI
Azad Duke Darbandi
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1740973635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 125.081763
- Practice address
- 4646 N Marine Dr
Chicago, IL 60640-5759 - Phone
- (773) 564-5225
- Fax
- (773) 564-5226
- NPI assigned
- May 29, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125.081763 | IL | Primary |
Addresses
Primary practice location
4646 N Marine Dr
Chicago, IL 60640-5759
Mailing address
4646 N. Marine Drive
C Elevators, 7TH FLR. # 7100
Chicago, IL 60640
Phone (773) 564-5225
Medicare participation
Medicare enrollment files- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.081763 | IL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685318400000",
"number": "1740973635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4646 N. MARINE DRIVE",
"address_2": "C ELEVATORS, 7TH FLR. # 7100",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60640",
"telephone_number": "773-564-5225",
"fax_number": "773-564-5226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4646 N MARINE DR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606405759",
"telephone_number": "773-564-5225",
"fax_number": "773-564-5226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DARBANDI",
"first_name": "AZAD",
"middle_name": "DUKE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-29",
"last_updated": "2023-05-29",
"certification_date": "2023-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125.081763",
"primary": true
}
],
"identifiers": [],
"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 May 29, 2023; 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.