Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | G141070 | IA |
N | 363LP2300X | Nurse Practitioner - Primary Care | 209.012344 | IL |
NPI | 1093106163 |
---|---|
Provider Name | Darcy Juraska |
First Address | Glen Ellyn, IL 60137-5579 |
Second Address | Glen Ellyn, IL 60137-5579 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2015 |
Last Update Date | 17/01/2022 |