Provider Demographics
NPI:1003483462
Name:WATKINS, DARIN II
Entity Type:Individual
Prefix:
First Name:DARIN
Middle Name:
Last Name:WATKINS
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14513 S BENSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BURNHAM
Mailing Address - State:IL
Mailing Address - Zip Code:60633-2205
Mailing Address - Country:US
Mailing Address - Phone:798-705-7624
Mailing Address - Fax:708-730-3328
Practice Address - Street 1:14513 S BENSLEY AVE
Practice Address - Street 2:
Practice Address - City:BURNHAM
Practice Address - State:IL
Practice Address - Zip Code:60633-2205
Practice Address - Country:US
Practice Address - Phone:798-705-7624
Practice Address - Fax:708-730-3328
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty