MEDICARE: FRANK R DI MARIA DO PC

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	207R00000X	Internal Medicine Physician		IL

General Provider Information

NPI Number	:	1487648689
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRANK R DI MARIA DO PC

Provider Business Mailing Address
First Line	:	900 OAKMONT LN
Second Line	:	STE 100
City	:	WESTMONT
State	:	IL
Zip	:	60559-5530
Country	:	US
Telephone Number	:	630-734-0200
Fax Number	:	630-734-1560

Provider Business Practice Location Address
First Line	:	3525 W PETERSON AVE
Second Line	:	STE 610
City	:	CHICAGO
State	:	IL
Zip	:	60659-3324
Country	:	US
Telephone Number	:	773-463-3263
Fax Number	:	630-734-1560

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FRANK R DI MARIA
Credential	:	DO
Telephone Number	:	773-296-8360

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	07/21/2022

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