Provider Demographics
NPI:1760207005
Name:DARREN JILEK PHD LICENSED PSYCHOLOGIST
Entity type:Organization
Organization Name:DARREN JILEK PHD LICENSED PSYCHOLOGIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:JILEK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:605-228-4877
Mailing Address - Street 1:39218 PRAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:MELLETTE
Mailing Address - State:SD
Mailing Address - Zip Code:57461-5206
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:634 S ROOSEVELT ST STE 4
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-6593
Practice Address - Country:US
Practice Address - Phone:605-228-4877
Practice Address - Fax:605-305-3604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty