MEDICARE: DR. MARLON DIAZ GARCIA 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	036-132501	IL
2	208M00000X	Hospitalist Physician	036-132501	IL

General Provider Information

NPI Number	:	1801102058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARLON DIAZ GARCIA M.D.

Provider Business Mailing Address
First Line	:	1926 W HARRISON ST
Second Line	:	APT 1000
City	:	CHICAGO
State	:	IL
Zip	:	60612-3737
Country	:	US
Telephone Number	:	312-852-1336
Fax Number	:

Provider Business Practice Location Address
First Line	:	1926 W HARRISON ST
Second Line	:	APT 1000
City	:	CHICAGO
State	:	IL
Zip	:	60612-3737
Country	:	US
Telephone Number	:	312-852-1336
Fax Number	:

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

Provider Enumeration Date	:	08/25/2010
Last Update Date	:	04/23/2021

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