Provider Demographics
NPI:1417964016
Name:CHESTER DURNAS, MD
Entity Type:Organization
Organization Name:CHESTER DURNAS, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:DURNAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:920-451-8142
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:920-451-8142
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:920-451-8142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E45738Medicare UPIN
IL210838Medicare ID - Type Unspecified