Provider Demographics
NPI:1104006584
Name:WORTHINGTON, DARRIN ALAN (AUD)
Entity Type:Individual
Prefix:DR
First Name:DARRIN
Middle Name:ALAN
Last Name:WORTHINGTON
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 N WESTMORELAND RD
Mailing Address - Street 2:800 BUILDING
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-1659
Mailing Address - Country:US
Mailing Address - Phone:847-535-6554
Mailing Address - Fax:847-535-7809
Practice Address - Street 1:660 N WESTMORELAND RD
Practice Address - Street 2:800 BUILDING
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1659
Practice Address - Country:US
Practice Address - Phone:847-535-6554
Practice Address - Fax:847-535-7809
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1470001260231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist