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Individual

KAZANDRA DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5524 W CERMAK RD STE 2, CICERO, IL 60804-2217
(708) 298-0766
Mailing address
PO BOX 746715, ATLANTA, GA 30374-6715
(773) 352-1515
(312) 929-0373

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.009814
IL

Other

Enumeration date
02/01/2022
Last updated
06/13/2025
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