MEDICARE: DIANA MARGARITA PLATA M.D.

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	036.149826	IL
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	036-149826	IL
3	207RB0002X	Obesity Medicine (Internal Medicine) Physician	036149826	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	036149826	OTHER	IL	STATE LICENSE

General Provider Information

NPI Number	:	1619329380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA MARGARITA PLATA M.D.

Provider Business Mailing Address
First Line	:	1410 N ARLINGTON HEIGHTS RD STE 200
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-4827
Country	:	US
Telephone Number	:	847-618-1640
Fax Number	:	847-618-1649

Provider Business Practice Location Address
First Line	:	1410 N ARLINGTON HEIGHTS RD STE 200
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-4827
Country	:	US
Telephone Number	:	847-618-1640
Fax Number	:	847-618-1649

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

Provider Enumeration Date	:	07/06/2016
Last Update Date	:	08/11/2023

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