Diesfeld, James R

Diesfeld, James R is an sole proprietor health care provider with primary practice located at 1044 N Francisco Ave Ste 404 , Chicago IL 60622-2743. He recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Diesfeld, James R can be contacted via phone (773) 868-6824.

Contact Information

Primary practice address
1044 N Francisco Ave Ste 404 Chicago IL 60622-2743
Phone: (773) 868-6824
Fax: (773) 868-6828
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 036086023 Illinois

Profile Details

NPI number 1497753214
LBN Legal business name Diesfeld, James R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 14th, 2005
Last updated May 20th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497753214 NPPES
Illinois Other 01605512 BLUE SHIELD OF ILLINOIS
Illinois MEDICAID 036086023 BLUE SHIELD OF ILLINOIS

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