Individual
LEON DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
4538 N. BEACON ST, CHICAGO, IL 60640
(773) 275-7200
Mailing address
1126 DANVERS, SCHAMBURG, IL 60194
(847) 895-1838
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006126
IL
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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