Individual
MICHAEL E DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1620 W HARRISON ST, CHICAGO, IL 60612-3801
(312) 942-5000
Mailing address
1620 W HARRISON ST, CHICAGO, IL 60612-3801
(312) 942-5000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
68265
MN
207RC0000X
Cardiovascular Disease Physician
Primary
036160971
IL
Other
Enumeration date
03/25/2019
Last updated
06/23/2022
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