Individual
MRS. ELLEN DIAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
620 WING ST, ELGIN, IL 60123-2800
(847) 529-9148
Mailing address
2830 RANDALL RIDGE DR, ELGIN, IL 60124-8043
(847) 529-9148
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1881109
IL
Other
Enumeration date
08/11/2016
Last updated
08/11/2016
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