Individual
DIANA MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5406 W FULLERTON AVENUE, CHICAGO, IL 60639-1427
(773) 466-7012
Mailing address
5406 W FULLERTON AVENUE, CHICAGO, IL 60639-1427
(773) 466-7012
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085011597
IL
Other
Enumeration date
10/24/2025
Last updated
10/24/2025
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