Provider Demographics
NPI:1407548514
Name:DARKO WELLNESS INC
Entity Type:Organization
Organization Name:DARKO WELLNESS INC
Other - Org Name:DARKO WELLNESS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DARKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-360-5020
Mailing Address - Street 1:1830 CARL DR
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE BEACH
Mailing Address - State:IL
Mailing Address - Zip Code:60073-1394
Mailing Address - Country:US
Mailing Address - Phone:224-360-5020
Mailing Address - Fax:
Practice Address - Street 1:333 PETERSON RD STE 240
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-1085
Practice Address - Country:US
Practice Address - Phone:224-360-5020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty