Individual
STEPHEN PETER DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
29330 N WAUKEGAN RD, LAKE BLUFF, IL 60044-5422
(224) 202-6732
Mailing address
7156 PENNSBURY LN, GURNEE, IL 60031-9113
(847) 530-7543
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160005414
IL
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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