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Individual

DR. JACOB DIAZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(708) 304-9700
Mailing address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
135.001250
IL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/31/2025
Last updated
06/17/2025
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