Individual
JENNIFER IDALY DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7222 W CERMAK RD STE 500, NORTH RIVERSIDE, IL 60546-1443
(866) 695-2221
(708) 853-9737
Mailing address
3345 S OAKLEY AVE, CHICAGO, IL 60608-6024
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
IL
Other
Enumeration date
11/18/2025
Last updated
11/19/2025
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