Basic Information
| Provider Information | |||||||||
| NPI: | 1437506557 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DIAZ QUINTERO | ||||||||
| FirstName: | LUIS | ||||||||
| MiddleName: | ALEJANDRO | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8117 PRESTON RD STE 800 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752256328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2147069018 | ||||||||
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| Practice Location | |||||||||
| Address1: | 251 E HURON ST | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606112908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3129262000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2016 | ||||||||
| LastUpdateDate: | 06/07/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 125068236 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 036149351 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | 036149351 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.