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NPI Code Detail

MEDICARE: DARREN JILEK PHD LICENSED PSYCHOLOGIST

MEDICARE: DARREN JILEK PHD LICENSED PSYCHOLOGIST
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
1103T00000XPsychologist

General Provider Information

NPI Number : 1760207005
Entity Type Code : Organization
Provider Name (Legal Business Name) : DARREN JILEK PHD LICENSED PSYCHOLOGIST
Provider Business Mailing Address
First Line : 39218 PRAIRIE RD
Second Line :
City : MELLETTE
State : SD
Zip : 57461-5206
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 634 S ROOSEVELT ST STE 4
Second Line :
City : ABERDEEN
State : SD
Zip : 57401-6593
Country : US
Telephone Number : 605-228-4877
Fax Number : 605-305-3604
Authorized Official
Title or Position : OWNER
Name : DARREN MICHAEL JILEK
Credential : PHD
Telephone Number : 605-228-4877
Provider Enumeration Date : 11/21/2024
Last Update Date : 11/21/2024

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Directions to “DARREN JILEK PHD LICENSED PSYCHOLOGIST ” Practice Location

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