Healthcare Provider Details

I. General information

NPI: 1770876146
Provider Name (Legal Business Name): DIPTI DIGHE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2011
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 W POLK ST 11TH FLOOR, ROOM 1136
CHICAGO IL
60612-3723
US

IV. Provider business mailing address

1900 W POLK ST 11TH FLOOR, ROOM 1136
CHICAGO IL
60612-3723
US

V. Phone/Fax

Practice location:
  • Phone: 312-864-4166
  • Fax:
Mailing address:
  • Phone: 312-864-4166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036117605
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number036117605
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: