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:
Health care specialties
Specialty | Code | License # | 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 2 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1497753214 | NPPES |
Illinois | Other | 01605512 | BLUE SHIELD OF ILLINOIS |
Illinois | MEDICAID | 036086023 | BLUE SHIELD OF ILLINOIS |
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