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Individual

HANNAH R DIETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6417 W IRVING PARK RD, CHICAGO, IL 60634-2437
(773) 777-7112
Mailing address
6337 N OAK PARK AVE, CHICAGO, IL 60631-2031
(773) 255-7131

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
05/24/2022
Last updated
05/24/2022
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