Organization
DIAMOND GASTROENTEROLOGY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILYSA DIAMOND D.O. (OWNER)
(708) 613-4417
Entity
Organization
Contact information
Practice address
1010 LAKE ST STE 424, OAK PARK, IL 60301-1185
(708) 613-4417
Mailing address
1010 LAKE ST STE 424, OAK PARK, IL 60301-1185
(708) 613-4417
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
36120184
IL
Other
Enumeration date
06/20/2014
Last updated
08/02/2023
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