Provider Demographics
NPI:1831190719
Name:DURRANI, ZIA U (MD)
Entity type:Individual
Prefix:
First Name:ZIA
Middle Name:U
Last Name:DURRANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-0129
Mailing Address - Country:US
Mailing Address - Phone:800-843-0355
Mailing Address - Fax:815-834-7211
Practice Address - Street 1:2100 CLEARWATER DR STE 100
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1931
Practice Address - Country:US
Practice Address - Phone:630-607-1000
Practice Address - Fax:630-607-1002
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036046890207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01623245OtherBLUE SHIELD OF ILLINOIS
IL036046890Medicaid
ILIL1162002Medicare PIN
IL01623245OtherBLUE SHIELD OF ILLINOIS
IL036046890Medicaid