NPI 1003147406

Amanda Marie Diamond, PAC

Practitioner Physician Assistant Crystal Lake, IL

Practice location

Address: 360 Station Drive Suite 201, Crystal Lake, IL 60014-7978
Phone: (815) 455-7200
Fax: (815) 455-9256

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 085002777 (IL)

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Registry record

NPI: 1003147406
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Jan 2010
Record last updated: 2 Aug 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.