Provider Demographics
NPI:1124124409
Name:STRAKO, DARIN (OD)
Entity type:Individual
Prefix:
First Name:DARIN
Middle Name:
Last Name:STRAKO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10436 SOUTHWEST HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:CHICAGO RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60415-2282
Mailing Address - Country:US
Mailing Address - Phone:708-586-4922
Mailing Address - Fax:708-423-4216
Practice Address - Street 1:10436 SOUTHWEST HWY STE 101
Practice Address - Street 2:
Practice Address - City:CHICAGO RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60415-2282
Practice Address - Country:US
Practice Address - Phone:085-864-9227
Practice Address - Fax:708-423-4216
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18004310A152W00000X
IL346001515152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK23551Medicare PIN