Provider Demographics
NPI:1831211903
Name:DARKEN, JILL ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:ELIZABETH
Last Name:DARKEN
Suffix:
Gender:F
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:US DEPT OF STATE, M/MED/QI
Mailing Address - Street 2:2401 E STREET NW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20522-0102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2401 E STREET NW
Practice Address - Street 2:DEPARTMENT OF STATE OFFICE OF MEDICAL SERVICES
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20520
Practice Address - Country:US
Practice Address - Phone:202-663-2453
Practice Address - Fax:202-663-3247
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine