Basic Information
| Provider Information | |||||||||
| NPI: | 1780676668 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DIAMOND | ||||||||
| FirstName: | MERLE | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1460 N HALSTED ST STE 501 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606422615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7733886390 | ||||||||
| FaxNumber: | 3128677101 | ||||||||
| Practice Location | |||||||||
| Address1: | 1460 N HALSTED ST STE 501 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606422615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7733886390 | ||||||||
| FaxNumber: | 3128677101 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2005 | ||||||||
| LastUpdateDate: | 12/26/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 036063282 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.