Provider Demographics
NPI:1093106163
Name:JURASKA, DARCY (APRN)
Entity Type:Individual
Prefix:
First Name:DARCY
Middle Name:
Last Name:JURASKA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5579
Mailing Address - Country:US
Mailing Address - Phone:630-956-1530
Mailing Address - Fax:
Practice Address - Street 1:248 GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5579
Practice Address - Country:US
Practice Address - Phone:630-956-1530
Practice Address - Fax:630-469-2552
Is Sole Proprietor?:No
Enumeration Date:2015-02-11
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.012344363LP2300X
IAG141070363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care