Individual
DR. DOUGLAS A DIEKEVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3000 HALSTED ST, SUITE 525, CHICAGO, IL 60603-5902
(773) 433-3130
Mailing address
3000 N HALSTED ST STE 525, CHICAGO, IL 60657-9269
(773) 433-3130
(440) 716-1605
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
016004442
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004442
—
IL
01
—
60010806
BLUE CROSS BLUE SHIELD
IL
01
—
93662603
UNITED HEALTHCARE
IL
01
—
P00251740
RAILROAD MEDICARE
IL
Enumeration date
03/16/2006
Last updated
12/28/2021
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