Healthcare Provider Details

I. General information

NPI: 1891113247
Provider Name (Legal Business Name): TRISHA DURHAM RN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 SILVER CROSS PAVILLION A SUITE 500
NEW LENOX IL
60451
US

IV. Provider business mailing address

907 N ELM ST STE 101
HINSDALE IL
60521-3644
US

V. Phone/Fax

Practice location:
  • Phone: 833-465-7246
  • Fax:
Mailing address:
  • Phone: 708-482-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209011492
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041374812
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: