Provider Demographics
NPI:1225126113
Name:DUROCHER, DONNA (PT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:DUROCHER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2222
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:168 DENSLOW ROAD
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028
Practice Address - Country:US
Practice Address - Phone:413-526-9924
Practice Address - Fax:413-526-9961
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5320225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA043527OtherCONNECTICARE GROUP NO
MA043527497OtherCONSOLIDATE HEALTH PLANS
11539624OtherCAQH
4265439OtherAETNA INDIVIDUAL NO
MAY61264OtherBLUE CROSS BLUE SHIELD GROUP NO
MA337847OtherTUFTS INDIVIDUAL NO
MA9715568Medicaid
MAP00420770OtherPALMETTO RR MEDICARE
MA000000035257OtherBOSTON MEDICAL HEALTHNET GROUP NO
MA043527497OtherGIC/UNICARE
MA043527497OtherPIONEER
080005320MA06OtherANTHEM BCBS
080005320MA07OtherANTHEM BCBS
MA28117OtherHEALTH NEW ENGLAND GROUP NO
MA690675OtherTUFTS GROUP NO
MA103355100OtherDEPARTMENT OF LABOR
MA000000035324OtherBOSTON MEDICAL HEALTH NET
043527497OtherAETNA GROUP NO
MA0704709Medicaid
MA972730OtherNETWORK HEALTH GROUP
Y65488OtherBLUE CROSS BLUE SHIELD INDIDUAL NO
MA1587870OtherCIGNA INDIVIDUAL NO
MA043527497OtherCIGNA GROUP NO
MA043527497OtherGREATWEST
MA043527497OtherNORTH REGIONS
MA043527497OtherUNITED HEALTH CARE
MA9715568Medicaid
080005320MA07OtherANTHEM BCBS