Provider Demographics
NPI:1740258201
Name:FLAHERTY, DARCY ANN (ATC)
Entity type:Individual
Prefix:MR
First Name:DARCY
Middle Name:ANN
Last Name:FLAHERTY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MISS
Other - First Name:DARCY
Other - Middle Name:ANN
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:1801 W LARCHMONT AVE
Mailing Address - Street 2:#313
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2487
Mailing Address - Country:US
Mailing Address - Phone:773-880-1702
Mailing Address - Fax:
Practice Address - Street 1:1915 S ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-1618
Practice Address - Country:US
Practice Address - Phone:312-674-9132
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer