Individual
DIANA MOHAMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6135 108TH ST, CHICAGO RIDGE, IL 60415-2190
(708) 636-2000
Mailing address
8524 GOLFVIEW DR, ORLAND PARK, IL 60462-2851
(929) 395-5914
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/15/2023
Last updated
08/24/2023
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