Individual
DR. ANTON N DIETZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., D.C.
Contact information
Practice address
1750 W HARRISON ST, CHICAGO, IL 60612-3825
(312) 942-6510
(312) 942-2867
Mailing address
26W171 ROOSEVELT RD, WHEATON, IL 60187-6002
(630) 909-7000
(630) 909-7002
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038011314
IL
208100000X
Physical Medicine & Rehabilitation Physician
036149703
IL
208100000X
Physical Medicine & Rehabilitation Physician
D0089692
MD
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
036149703
IL
208600000X
Surgery Physician
125.069633
IL
Other
Enumeration date
01/13/2009
Last updated
09/12/2023
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