Individual
DIANELLA V DIZON-MENEZES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8311 W ROOSEVELT RD, ADVANCED PSYCHIATRIC SERVICES, FOREST PARK, IL 60130
(708) 488-4968
(708) 366-1017
Mailing address
PO BOX 5800, RIVER FOREST, IL 60305
(708) 488-4968
(708) 366-1017
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036056061
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036056061
—
IL
Enumeration date
05/16/2008
Last updated
05/16/2008
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