MEDICARE: DARRON DAMASIUS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	372600000X	Adult Companion
2	372600000X	Adult Companion		IL

General Provider Information

NPI Number	:	1275044000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARRON DAMASIUS

Provider Business Mailing Address
First Line	:	500 LAKE COOK RD STE 350
Second Line	:
City	:	DEERFIELD
State	:	IL
Zip	:	60015-5268
Country	:	US
Telephone Number	:	847-558-2228
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 LAKE COOK RD STE 350
Second Line	:
City	:	DEERFIELD
State	:	IL
Zip	:	60015-5268
Country	:	US
Telephone Number	:	847-558-2228
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2017
Last Update Date	:	10/19/2017

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Directions to “ DARRON DAMASIUS ” Practice Location

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