NPIMap

Organization Active NPI

Darko Wellness Inc

Doing business as Darko Wellness LLC

  • Nurse Practitioner
  • Libertyville, IL
National Provider Identifier
1407548514
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
DARKO WELLNESS INC
Doing business as
Darko Wellness LLC
Practice address
333 Peterson Rd Ste 240
Libertyville, IL 60048-1085
Phone
(224) 360-5020
NPI assigned
May 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Aisha DarkoNPI 1285304105
Title
Owner
Phone
(224) 360-5020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

333 Peterson Rd Ste 240
Libertyville, IL 60048-1085

Mailing address

1830 Carl Dr
Round Lake Beach, IL 60073-1394
Phone (224) 360-5020

Other names 1

  • DARKO WELLNESS LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230728001648 IL Part B Supplier - Clinic/Group Practice 3971964545 Receives reassigned benefits from 1 practitioner
Practice locations: Libertyville, IL; Round Lake Beach, IL

National Provider Directory

National Provider Directory
Tax ID family
Darko Wellness Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695254400000",
    "number": "1407548514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 CARL DR",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600731394",
            "telephone_number": "224-360-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 PETERSON RD STE 240",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481085",
            "telephone_number": "224-360-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARKO WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A",
        "authorized_official_last_name": "DARKO",
        "authorized_official_first_name": "AISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-360-5020"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DARKO WELLNESS LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DARKO WELLNESS LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.