Individual
DIANA JULIA JAIME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1301 COPPERFIELD AVE, SUITE 203, JOLIET, IL 60432-2056
(815) 727-4292
(815) 727-5395
Mailing address
1301 COPPERFIELD AVE, SUITE 203, JOLIET, IL 60432-2056
(815) 727-4292
(815) 727-5395
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
336060372
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9928146
BC/BS
IL
Enumeration date
02/25/2007
Last updated
01/05/2012
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