Provider Demographics
NPI:1417568577
Name:DARKO, HENRY OA
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:OA
Last Name:DARKO
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 1:1830 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:177-343-0072
Mailing Address - Fax:
Practice Address - Street 1:1830 CARL DR
Practice Address - Street 2:
Practice Address - City:ROUND LAKE BEACH
Practice Address - State:IL
Practice Address - Zip Code:60073-1394
Practice Address - Country:US
Practice Address - Phone:177-343-0072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)