Individual
DR. DIANA TABOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
430 PENNSYLVANIA AVE STE 240, GLEN ELLYN, IL 60137-4464
(630) 510-6929
(630) 355-3257
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016005675
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659786150
—
IL
Enumeration date
06/24/2014
Last updated
08/23/2023
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