Provider Demographics
NPI:1891938742
Name:DURK, JESSICA ZHOU (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ZHOU
Last Name:DURK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:ZHOU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:39720 SQUIRE RD
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-3713
Mailing Address - Country:US
Mailing Address - Phone:248-470-0829
Mailing Address - Fax:
Practice Address - Street 1:6100 W 96TH ST STE 125
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46278-6006
Practice Address - Country:US
Practice Address - Phone:317-715-1800
Practice Address - Fax:317-715-6200
Is Sole Proprietor?:No
Enumeration Date:2009-04-08
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361356202085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology