Individual
DIANA-MARIE F BIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1460 N HALSTED ST STE 401, CHICAGO, IL 60642-2607
(773) 880-0320
(312) 204-5516
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036090536
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036090536
—
IL
Enumeration date
06/03/2006
Last updated
10/05/2022
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