Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DIANE MARTINEZ DADIVAS, RD
Active Sole ProprietorPediatric Nutrition · NILES, IL
Registration Details
- NPI Number
- 1790090033
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 11, 2010 (15.696018853139 yrs)
- Last Updated
- Jun 12, 2020
- License
-
164.005298 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
8439 N CLIFTON AVENILES, IL, 607141803Browse IL providers · Browse ZIP 60714
- Phone
- 2819018481
- Fax
- 8332714447
- Primary Specialty
-
Pediatric Nutrition
133VN1004X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.