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Individual

MARK D DIAMOND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2100 GLENWOOD AVE, JOLIET, IL 60435-5487
(815) 725-2121
(815) 744-3117
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036091440
IL
208M00000X
Hospitalist Physician
Primary
036091440
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036091440
IL
Enumeration date
01/25/2006
Last updated
08/07/2023
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