Organization
DIAMOND HEADACHE CLINIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MERLE L DIAMOND MD (MANAGING DIRECTOR)
(773) 388-6390
Entity
Organization
Contact information
Practice address
1460 N HALSTED ST STE 501, CHICAGO, IL 60642-2615
(773) 388-6390
(312) 867-7101
Mailing address
1460 N HALSTED ST STE 501, CHICAGO, IL 60642-2615
(773) 388-6390
(312) 867-7101
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1616611
BCBS
IL
Enumeration date
03/29/2007
Last updated
12/26/2017
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