Provider Demographics
NPI:1679801476
Name:DARA, NKEIRUKA O (MD)
Entity type:Individual
Prefix:DR
First Name:NKEIRUKA
Middle Name:O
Last Name:DARA
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 1:2451 W HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-1521
Mailing Address - Country:US
Mailing Address - Phone:872-302-9909
Mailing Address - Fax:
Practice Address - Street 1:1555 W HOWARD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-1707
Practice Address - Country:US
Practice Address - Phone:773-265-0300
Practice Address - Fax:773-265-8467
Is Sole Proprietor?:No
Enumeration Date:2009-12-07
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036122639207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
367830Medicare PIN