MEDICARE: JAMIL B DIHU D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	036124341	IL
2	207R00000X	Internal Medicine Physician	036124341	IL

General Provider Information

NPI Number	:	1154508570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIL B DIHU D.O.

Provider Business Mailing Address
First Line	:	1769 CAMPBELL AVE
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60016-6771
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2650 RIDGE AVE
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1718
Country	:	US
Telephone Number	:	847-570-2509
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2008
Last Update Date	:	10/25/2023

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Directions to “ JAMIL B DIHU D.O.” Practice Location

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