Individual
DIANE DICKENS-ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSES RN
Contact information
Practice address
5700 W. CHICAGO AVE., CHICAGO, IL 60651
(773) 287-7601
Mailing address
5700 W. CHICAGO AVE., CHICAGO, IL 60651
(773) 287-7601
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
041-198732
IL
225700000X
Massage Therapist
Primary
529467-07
IL
374T00000X
Religious Nonmedical Nursing Personnel
041-198732
IL
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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