Organization
DIANE TATE MD
Active
Other names
DIANE TATE MD
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE TATE M.D. (MEDICAL DOCTOR)
(773) 775-1622
Entity
Organization
Contact information
Practice address
6547 N AVONDALE AVE, SUITE 001, CHICAGO, IL 60631-1573
(773) 775-1622
Mailing address
6547 N AVONDALE AVE, SUITE 001, CHICAGO, IL 60631-1573
(773) 775-1622
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
036042759
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036042759
—
IL
Enumeration date
09/23/2008
Last updated
09/23/2008
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