DR. DIAMOND DONALD DETTORE (NPI# 1285646588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285646588 |
| Entity Type | Individual |
| Full Name | DR. DIAMOND DONALD DETTORE |
| Credential | M.D. |
| Practice Address |
4705 Willow Springs Rd Ste 203 La Grange IL 60525-6150 |
| Practice Telephone | 7087951520 |
| Practice Fax Number | 7087951543 |
| Mailing Telephone | 7087951520 |
| Mailing Fax Number | 7087951543 |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2018-10-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036039227 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 21608845 | 01 |
| Street Address |
4705 WILLOW SPRINGS RD STE 203 |
| City | LA GRANGE |
| State | IL |
| Zip Code | 60525-6150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063923837 | Cheryl Buhrke | Speech-Language Pathologist | 1301 W. Cossitt Ave., La Grange, IL 60525 | 2017-10-19 |
| 1881113462 | Karen Aluise | Speech-Language Pathologist | 6818 Joliet Rd. #2, Indian Head Park, IL 60525 | 2017-09-14 |
| 1689126997 | Adriana Digianfilippo | Occupational Therapist | 18 N. Catherine, Lagrange, IL 60525 | 2016-11-03 |
| 1679953582 | Paulina Pinzon | Counselor | 6548 Laurel Avenue, Indian Head Park, IL 60525 | 2015-06-05 |
| 1639446925 | Aarti Parikh | Pharmacist | 6600 S. Willow Springs Rd, Indian Head Park, IL 60525 | 2011-11-30 |
| 1831476795 | Jessica E Feller | Physician Assistant | 6555 South Willow Springs Road, Suite 6, Countryside, IL 60525 | 2011-11-07 |
| 1477833218 | Robyn Lee Frendling | Behavioral Analyst | 9649 W. 55th St, Countryside, IL 60525 | 2011-08-25 |
| 1457630543 | Kerri E Kabela | Physical Therapist | 705 W. Plainfield Rd, Suite 1, Countryside, IL 60525 | 2011-08-08 |
| 1275826984 | G&u Orthopedic, LLC | Durable Medical Equipment & Medical Supplies | 106 W. Calendar Ave., 127, La Grange, IL 60525 | 2011-05-27 |
| 1952609752 | Athletic and Therapeutic Institute of Naperville, LLC | Physical Therapist | 705 W. Plainfield Road, Suite 1, Countryside, IL 60525 | 2011-03-03 |
| Find all providers in zip 60525 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902347313 | Samyuktha Vani Kemparajurs | Family Medicine | 501 Parker Pl Unit 200, La Grange, KY 40031-2229 | 2017-03-17 |
| 1265843874 | Kinuyo Henderson | Family Medicine | 1253 N. Von Minden, La Grange, TX 78945 | 2014-05-16 |
| 1497199368 | Oldham County Ministerial Association | Family Medicine | 1025 Sanibel Way, Suite E, La Grange, KY 40031-9156 | 2013-04-23 |
| 1073779500 | Tejas Health Care | Family Medicine | 890 E Travis St, La Grange, TX 78945-2364 | 2008-08-04 |
| 1801070974 | Bill D Nolen Pa | Family Medicine | 2 Saint Marks Pl Ste 112, La Grange, TX 78945-1256 | 2007-12-24 |
| 1689875783 | Marcy Dering | Family Medicine | 23 Calendar Ave, La Grange, IL 60525-2365 | 2007-05-29 |
| 1205042975 | Clodagh Therese Ryan | Family Medicine | 1400 W 47th St Ste 1, La Grange, IL 60525-6148 | 2007-05-16 |
| 1245457282 | Andrea Ocampo Colada | Family Medicine | 1323 Memorial Drive, Ste 214, La Grange, IL 60525 | 2007-04-19 |
| 1992886717 | Nasreen Ansari | Family Medicine | 23 Calendar Ct, La Grange, IL 60525-2365 | 2006-10-18 |
| 1922194083 | Barry Brian Sosnin Jr. | Family Medicine | 1019 Commerce Pkwy, La Grange, KY 40031-8779 | 2006-10-05 |
| Find all providers in LA GRANGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.