NPIMap

Organization Active NPI

Physician at Your Door

  • Family Medicine Physician
  • Bolingbrook, IL
National Provider Identifier
1831520071
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PHYSICIAN AT YOUR DOOR
Practice address
218 Eagle CT
Unit#D
Bolingbrook, IL 60440-5732
Phone
(630) 401-6779
NPI assigned
Dec 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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

Authorized official

Name
Robert K Duncan
Title
President
Phone
(630) 401-6779

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

218 Eagle CT
Unit#D
Bolingbrook, IL 60440-5732

Mailing address

218 Eagle CT
Unit#D
Bolingbrook, IL 60440-5732
Phone (630) 401-6779

National Provider Directory

National Provider Directory
Tax ID family
Physician at Your Door2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9557/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1831520071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 EAGLE CT",
            "address_2": "UNIT#D",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604405732",
            "telephone_number": "630-401-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 EAGLE CT",
            "address_2": "UNIT#D",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604405732",
            "telephone_number": "630-401-6779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN AT YOUR DOOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-12",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-401-6779"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; 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.