Provider Demographics
NPI:1205484458
Name:DARRAGH, BERNADETTE
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:
Last Name:DARRAGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41W847 BEITH ROAD
Mailing Address - Street 2:
Mailing Address - City:CAMPTON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60119-9566
Mailing Address - Country:US
Mailing Address - Phone:630-488-6494
Mailing Address - Fax:
Practice Address - Street 1:1140 N MCLEAN BLVD STE I
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-1782
Practice Address - Country:US
Practice Address - Phone:847-695-3680
Practice Address - Fax:847-695-4552
Is Sole Proprietor?:No
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical