Individual
DIANA LEIGH VORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1191 FORTUNE BLVD STE 2, SHILOH, IL 62269-7474
(618) 622-7546
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036156222
IL
207N00000X
Dermatology Physician
64202
MN
Other
Enumeration date
04/21/2017
Last updated
09/02/2021
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