Provider Demographics
NPI:1538272604
Name:DUKE, REBECCA JANE (MD)
Entity type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:JANE
Last Name:DUKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3929 N CENTRAL AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-3072
Mailing Address - Country:US
Mailing Address - Phone:773-202-7703
Mailing Address - Fax:773-202-7708
Practice Address - Street 1:3929 N CENTRAL AVE STE 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-3072
Practice Address - Country:US
Practice Address - Phone:773-202-7703
Practice Address - Fax:773-202-7708
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036079316174400000X
TN53691207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist