NPIMap

Organization Active NPI

Medical Director on Demand LLC

  • Registered Nurse
  • Chicago, IL
National Provider Identifier
1992298293
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041-169074 Issued in IL
Legal business name
MEDICAL DIRECTOR ON DEMAND LLC
Practice address
47 W. Polk Street
Suite 301
Chicago, IL 60605
Phone
(312) 427-0774
Fax
(312) 427-0775
NPI assigned
Jun 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Authorized official

Name
Ms. Barbara Anne Duffy, RN,MA
Title
Director, Officer
Phone
(312) 965-0499

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X 041-169074 IL Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 036.115000 IL

Addresses

Primary practice location

47 W. Polk Street
Suite 301
Chicago, IL 60605

Mailing address

47 W. Polk Street
Suite 301
Chicago, IL 60605
Phone (312) 427-0774

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528675200000",
    "number": "1992298293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 W. POLK STREET",
            "address_2": "SUITE 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60605",
            "telephone_number": "312-427-0774",
            "fax_number": "312-427-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 W. POLK STREET",
            "address_2": "SUITE 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60605",
            "telephone_number": "312-427-0774",
            "fax_number": "312-427-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DIRECTOR ON DEMAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-06-11",
        "status": "A",
        "authorized_official_last_name": "DUFFY",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "DIRECTOR, OFFICER",
        "authorized_official_telephone_number": "312-965-0499",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN,MA"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-169074",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.115000",
            "primary": false
        }
    ],
    "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 Jun 11, 2018; 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.