| Diamond Gastroenterology SC | |
|
1010 Lake St Ste 424 Oak Park IL 60301-1185 | |
| (708) 613-4417 | |
| Not Available |
| Full Name | Diamond Gastroenterology SC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1010 Lake St Ste 424, Oak Park, Illinois |
| Authorized Official Name and Position | Ilysa Diamond (OWNER) |
| Authorized Official Contact | 7086134417 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diamond Gastroenterology SC 1010 Lake St Ste 424 Oak Park IL 60301-1185 Ph: (708) 613-4417 | Diamond Gastroenterology SC 1010 Lake St Ste 424 Oak Park IL 60301-1185 Ph: (708) 613-4417 |
| NPI Number | 1043624752 |
|---|---|
| Provider Enumeration Date | 06/20/2014 |
| Last Update Date | 08/02/2023 |
| Certification Date | 08/02/2023 |
| Medicare PECOS PAC ID | 8022235837 |
|---|---|
| Medicare Enrollment ID | O20140818002229 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043624752 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 36120184 (Illinois) | Primary |
| Provider Name | Ilysa R Diamond |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356596332 PECOS PAC ID: 6204998396 Enrollment ID: I20130429000632 |
James Lo M.D., Mary Lo M.D. S.C. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1140 W Lake St, Suite 402, Oak Park, IL 60301 Phone: 708-848-0330 |
Maria Slobodian MD SC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Erie Ct, Suite#7040, Oak Park, IL 60302 Phone: 708-848-5410 Fax: 708-848-6539 |
Anarkali Internists SC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1035 N Marion St, Oak Park, IL 60302 Phone: 773-354-7041 |
Pcc Community Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14 W Lake St, Oak Park, IL 60302 Phone: 708-383-0113 Fax: 708-383-9911 |
Midwest Gi and Hepatology, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 610 S Maple Ave, Suite 2600, Oak Park, IL 60304 Phone: 708-290-1010 |
Pedios, Ltd. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 260 Chicago Ave, Oak Park, IL 60302 Phone: 708-383-8070 Fax: 708-383-0811 |