Provider Demographics
NPI:1114357092
Name:DARKI, ABDUL HUSSEIN
Entity Type:Individual
Prefix:MR
First Name:ABDUL
Middle Name:HUSSEIN
Last Name:DARKI
Suffix:
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 1:11808 SOUTH PALASKI STREET
Mailing Address - Street 2:
Mailing Address - City:ALSIP
Mailing Address - State:IL
Mailing Address - Zip Code:60803-1608
Mailing Address - Country:US
Mailing Address - Phone:708-668-2560
Mailing Address - Fax:708-489-6249
Practice Address - Street 1:11808 S PULASKI RD
Practice Address - Street 2:
Practice Address - City:ALSIP
Practice Address - State:IL
Practice Address - Zip Code:60803
Practice Address - Country:US
Practice Address - Phone:708-668-2560
Practice Address - Fax:708-489-6249
Is Sole Proprietor?:No
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-067615208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics