Provider Demographics
NPI:1881032100
Name:DURALL, JAMES HAMILTON (CRNA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:HAMILTON
Last Name:DURALL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 S CLARK ST
Mailing Address - Street 2:#2106
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-1743
Mailing Address - Country:US
Mailing Address - Phone:520-360-6688
Mailing Address - Fax:
Practice Address - Street 1:730 S CLARK ST
Practice Address - Street 2:#2106
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-1743
Practice Address - Country:US
Practice Address - Phone:520-360-6688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-09
Last Update Date:2013-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28208375A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered