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Individual

HOMER DIADULA

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
157 TOMLIN CIR, BURR RIDGE, IL 60527-4886
(773) 237-3354
(630) 850-7306
Mailing address
157 TOMLIN CIR, BURR RIDGE, IL 60527-4886
(773) 237-3354
(630) 850-7306

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036082531
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01621679
BCBS OF IL
IL
05
036082531
IL
Enumeration date
12/20/2005
Last updated
09/29/2015
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