Provider Demographics
NPI:1992254601
Name:ARDELEAN, DARIUS
Entity type:Individual
Prefix:
First Name:DARIUS
Middle Name:
Last Name:ARDELEAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6645 N KNOX
Mailing Address - Street 2:
Mailing Address - City:LINCOLWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-3327
Mailing Address - Country:US
Mailing Address - Phone:847-904-3263
Mailing Address - Fax:
Practice Address - Street 1:6645 N KNOX AVE
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-3327
Practice Address - Country:US
Practice Address - Phone:847-904-3263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer