Diamond Gastroenterology SC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

36120184 Issued in IL

Legal business name

DIAMOND GASTROENTEROLOGY SC

Practice address

1010 Lake St Ste 424
Oak Park, IL 60301-1185

Phone

(708) 613-4417

NPI assigned

Jun 20, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ilysa Diamond, D.O.NPI 1356596332

Title

Owner

Phone

(708) 613-4417

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8882/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ilysa R Diamond, DO

  • Gastroenterology Physician
  • Oak Park, IL
  • NPI 1356596332
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1043624752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST STE 424",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011185",
            "telephone_number": "708-613-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST STE 424",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011185",
            "telephone_number": "708-613-4417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3101 N Harlem Ave # 3115",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606344543",
            "country_code": "US",
            "telephone_number": "773-889-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Erie Ct",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603022519",
            "country_code": "US",
            "telephone_number": "708-613-4417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DIAMOND GASTROENTEROLOGY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-20",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A",
        "authorized_official_last_name": "DIAMOND",
        "authorized_official_first_name": "ILYSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-613-4417",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "36120184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darla Kim Dewolff, PHD, CPNP, MPH
• Logesh Dharmar
• Kelsey Di Pirro, LMSW
• Dialyze Direct Il LLC
• Archimedes Sison Diamante, M.D.
• Ilysa R Diamond, DO
• Elizabeth Ann Dillon
• Dina Vatcha LLC
• Heba Dina
• Sara Elizabeth Dion, LCPC

• Gastroenterology Physician in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.