Provider Demographics
NPI:1831907906
Name:DIAZ, MARIBEL (ND)
Entity type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 W 23RD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-4106
Mailing Address - Country:US
Mailing Address - Phone:208-969-1128
Mailing Address - Fax:
Practice Address - Street 1:650 N DEARBORN ST STE 800
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-3874
Practice Address - Country:US
Practice Address - Phone:312-335-9330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath