Provider Demographics
NPI:1033129788
Name:DURNAS, CHESTER (MD)
Entity Type:Individual
Prefix:
First Name:CHESTER
Middle Name:
Last Name:DURNAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6785 WEAVER RD
Mailing Address - Street 2:STE D
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114-8055
Mailing Address - Country:US
Mailing Address - Phone:815-633-8586
Mailing Address - Fax:
Practice Address - Street 1:6785 WEAVER RD
Practice Address - Street 2:STE D
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114-8055
Practice Address - Country:US
Practice Address - Phone:815-633-8586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036073836207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL216297Medicare PIN
IL210838Medicare ID - Type Unspecified
E45738Medicare UPIN