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Individual

SEAN DIAMOND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2160 S 1ST AVE, (16621 S. 107TH COURT, OARLAND PARK, IL. 60467), MAYWOOD, IL 60153
(708) 873-7355
(708) 460-6138
Mailing address
2160 S 1ST AVE, (16621 S. 107TH COURT, OARLAND PARK, IL. 60467), MAYWOOD, IL 60153
(708) 873-7355
(708) 460-6138

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
36072032
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
36072032
IL
Enumeration date
02/15/2006
Last updated
06/24/2021
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