Healthcare Provider Details

I. General information

NPI: 1811092067
Provider Name (Legal Business Name): BELINDA DURBIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 W PARK AVE
CHAMPAIGN IL
61820-3929
US

IV. Provider business mailing address

1936 ELOISE LN
WHITE HEATH IL
61884-9538
US

V. Phone/Fax

Practice location:
  • Phone: 217-373-2430
  • Fax: 217-373-2444
Mailing address:
  • Phone: 217-369-7532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: