Individual
WILLIAM JACOB DIETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1520 W HARRISON ST, CHICAGO, IL 60607-3106
(312) 942-0712
Mailing address
1520 W HARRISON ST, CHICAGO, IL 60607-3106
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
125086179
IL
390200000X
Student in an Organized Health Care Education/Training Program
125.086179
IL
Other
Enumeration date
09/14/2023
Last updated
08/05/2025
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