Elissa Diestelkamp

NPI #1730615279 in Oswego, Illinois

Provider Information

NPI Number: 1730615279
Entity Type: Individual
Name: Elissa Diestelkamp
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: May 3, 2017
Last Updated: May 3, 2017

Practice Location

Address: 28 WINGATE DR
City: Oswego
State: Illinois
ZIP Code: 60543-7911
Phone: (630) 768-5685

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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