Provider Demographics
NPI:1518583210
Name:TAIWO DUROWADE LLC
Entity Type:Organization
Organization Name:TAIWO DUROWADE LLC
Other - Org Name:DARDUR MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OB/GYN
Authorized Official - Prefix:DR
Authorized Official - First Name:TAIWO
Authorized Official - Middle Name:F
Authorized Official - Last Name:DUROWADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-487-1058
Mailing Address - Street 1:1831 218TH PL
Mailing Address - Street 2:
Mailing Address - City:SAUK VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60411-4914
Mailing Address - Country:US
Mailing Address - Phone:309-750-2638
Mailing Address - Fax:
Practice Address - Street 1:19150 KEDZIE AVE STE 100
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-4540
Practice Address - Country:US
Practice Address - Phone:312-487-1058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty