Provider Demographics
NPI:1356860928
Name:DIVERSE INVESTMENTS INC.
Entity Type:Organization
Organization Name:DIVERSE INVESTMENTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:773-610-9738
Mailing Address - Street 1:848 DODGE AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-1506
Mailing Address - Country:US
Mailing Address - Phone:773-610-9738
Mailing Address - Fax:773-486-5022
Practice Address - Street 1:3407 W FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-2497
Practice Address - Country:US
Practice Address - Phone:773-954-4438
Practice Address - Fax:773-486-5022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-14
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies