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Individual

DR. JESUS RENE DADIVAS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8074 N MILWAUKEE AVE, NILES, IL 60714-2802
(847) 834-4101
(224) 506-3403
Mailing address
1402 W BUSSE AVE, MOUNT PROSPECT, IL 60056-2975
(847) 834-4101

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036130079
IL

Other

Enumeration date
04/05/2011
Last updated
03/28/2026
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