Provider Demographics
NPI:1407215064
Name:DURA, LLC
Entity Type:Organization
Organization Name:DURA, LLC
Other - Org Name:DURA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:NDIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ONYEJIAKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-283-3456
Mailing Address - Street 1:8 S MICHIGAN AVE
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-3357
Mailing Address - Country:US
Mailing Address - Phone:312-283-3456
Mailing Address - Fax:312-380-0153
Practice Address - Street 1:8 S MICHIGAN AVE
Practice Address - Street 2:SUITE 2500
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-3357
Practice Address - Country:US
Practice Address - Phone:312-283-3456
Practice Address - Fax:312-380-0153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-11
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X, 2084P0804X, 2084S0010X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0010XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySports MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty