Provider Demographics
NPI:1710910880
Name:HARNISCH, DARIN O'CONNOR (MD)
Entity Type:Individual
Prefix:DR
First Name:DARIN
Middle Name:O'CONNOR
Last Name:HARNISCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 N MILWAUKEE AVE
Mailing Address - Street 2:STE 231
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-3159
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7900 N MILWAUKEE AVE
Practice Address - Street 2:STE 231
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-3159
Practice Address - Country:US
Practice Address - Phone:847-663-9400
Practice Address - Fax:847-663-9827
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-106895174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILI06691Medicare UPIN