DEIDRE ANNE DIETZ (NPI# 1245436625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245436625 |
| Entity Type | Individual |
| Full Name | DEIDRE ANNE DIETZ |
| Other Name | DEIDRE ANNE SCHUPBACH |
| Credential | M.D. |
| Practice Address |
3223 W 63rd Street Chicago IL 60629 |
| Mailing Address |
9119 S Exchange Ave Chicago IL 60617-4225 |
| Practice Telephone | 7737685000 |
| Mailing Telephone | 7737685000 |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2011-09-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036.125780 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | TRAINING | RS2000-0373 | 01 |
| Street Address |
3223 W 63RD STREET |
| City | CHICAGO |
| State | IL |
| Zip Code | 60629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053946392 | T & M Care LLC | In Home Supportive Care | 7230 S Talman, Apt 4, Chicago, IL 60629 | 2020-03-06 |
| 1841847811 | Jacqueline Ann Milton | Technician | 6720 South Keating, Chicago, IL 60629 | 2019-08-23 |
| 1194202085 | Andrea Mosqueda | Counselor | 4217 W 59th St, Chicago, IL 60629 | 2018-07-23 |
| 1316439235 | Saliha Awais | Dentist | 5521 S. Kedzie Ave. Suite 105, Chicago, IL 60629 | 2018-06-06 |
| 1356833255 | Irfana Ilyas | Dentist | 2403,5521 S Kedzie Ave, Suite 105, Chicago, IL 60629 | 2018-06-06 |
| 1427547538 | Holy Cross Hospital | Psychiatric Unit | 2701 West 68th Street, Chicago, IL 60629 | 2018-05-03 |
| 1871003715 | Siddhi Vinayak Dental | Clinic/Center | 5521 S Kedzie Ave, Unit 105, Chicago, IL 60629 | 2017-10-05 |
| 1477092328 | Debra Shepard | Social Worker | 2601 W. Marquette Rd., Catholic Charities, Chicago, IL 60629 | 2017-02-13 |
| 1255777108 | Jacquelyn Jones | Developmental Therapist | 3108 West Marquette Road Apartment 1-b, Chicago, IL 60629 | 2013-05-20 |
| 1124368030 | Claudia Ballesteros | Interpreter | 5631 S. Richmond, Chicago, IL 60629 | 2013-03-01 |
| Find all providers in zip 60629 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1124645700 | Timothy Alan Williams Jr. | Family Medicine | 1625 E 75th St Fl 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1194340026 | Kaysha Lynne Ribao | Family Medicine | 2116 S Springfield Ave, Chicago, IL 60623-2465 | 2020-06-16 |
| 1932724341 | Toni Kurian | Family Medicine | 1550 S Indiana Ave Apt 407, Chicago, IL 60605-4822 | 2020-06-11 |
| 1528689486 | Thurman J Robertson | Family Medicine | 1950 W. Polk Street, 7th Floor, Chicago, IL 60612-3714 | 2020-05-01 |
| 1629697297 | Lyndsey Danielle Johnson | Family Medicine | 2804 W Walton St, Chicago, IL 60622-4450 | 2020-04-13 |
| 1730708884 | Iruoma Genevieve Nwangwu | Family Medicine | 1950 W Polk Street, Chicago, IL 60612-3714 | 2020-04-09 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.