Healthcare Provider Details

I. General information

NPI: 1265878193
Provider Name (Legal Business Name): MICHAEL JAMES DIMARCO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2013
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8125 RIVER DR STE 102
MORTON GROVE IL
60053-2642
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 847-470-1720
  • Fax: 847-470-1723
Mailing address:
  • Phone: 563-344-2240
  • Fax: 319-356-3949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-44888
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number036143520
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA137583
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: