Individual
KEVIN DIAMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6225 N STATE HIGHWAY 161, IRVING, TX 75038-2223
(214) 687-0691
Mailing address
12109 S 87TH AVE, PALOS PARK, IL 60464-1206
(312) 545-7782
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209013002
IL
Other
Enumeration date
08/13/2015
Last updated
08/13/2015
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