Individual
ROSE DIAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9660 WICKER AVE FL 2, SAINT JOHN, IN 46373-9487
(219) 226-2236
Mailing address
1460 N. HALSTED, SUITE 503, CHICAGO, IL 60639-6158
(773) 472-1444
(312) 787-4424
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01082758A
IN
207V00000X
Obstetrics & Gynecology Physician
036081535
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036081535
—
IL
01
—
1620171
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/24/2006
Last updated
08/14/2019
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