Healthcare Provider Details

I. General information

NPI: 1962174409
Provider Name (Legal Business Name): DARAH CUMMINS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2021
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 US HIGHWAY 45 N
ELDORADO IL
62930-3766
US

IV. Provider business mailing address

1412 US HIGHWAY 45 N
ELDORADO IL
62930-3766
US

V. Phone/Fax

Practice location:
  • Phone: 618-273-3326
  • Fax:
Mailing address:
  • Phone: 618-273-3326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209.024118
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.024118
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: