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Individual
DIANA I DOLL
Active
Individual
DIANA I DOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036-085495
IL
207Q00000X
Family Medicine Physician
036085495
IL
207Q00000X
Family Medicine Physician
Primary
28206
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036085495
—
IL
05
—
036085495-1
—
IL
05
—
1942263405
—
IL
01
—
36085495
BCBS
IL
01
—
P00219477
RAILROAD MEDICARE
IL
Enumeration date
04/07/2006
Last updated
01/20/2017
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