# JR DADIVAS JR. MD., SC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912322355
- **Authorized official:** JESUS R DADIVAS MD (OWNER)
- **Authorized official phone:** (312) 588-1104

## Contact information

- **Practice address:** 730 S DEARBORN ST, CHICAGO, IL 60605-1838
- **Practice address phone:** (312) 588-1104
- **Practice address fax:** (312) 577-0884
- **Mailing address:** 730 S DEARBORN ST, CHICAGO, IL 60605-1838
- **Mailing address phone:** (312) 588-1104
- **Mailing address fax:** (312) 577-0884

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/21/2014
- **Last updated:** 02/21/2014