Individual
DIEGO RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
251 E HURON ST STE 16-738, CHICAGO, IL 60611-2908
(312) 926-5924
(312) 926-6134
Mailing address
251 E HURON ST STE 16-738, CHICAGO, IL 60611-2908
(312) 926-5924
(312) 926-6134
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007712
IL
Other
Enumeration date
08/23/2019
Last updated
01/06/2021
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