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Individual

DR. DIANA MARTA FATYGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
711 W NORTH AVE, CHICAGO, IL 60610-1174
(312) 337-1982
Mailing address
711 W NORTH AVE, CHICAGO, IL 60610-1174
(312) 337-1982

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036143778
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
125.065916
STATE OF ILLINOIS TEMPORARY LICENSE NUMBER
IL
Enumeration date
05/26/2014
Last updated
04/13/2026
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