Provider Demographics
NPI:1699263632
Name:KREPPEL, DIANA ALEXANDRA (MD)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:ALEXANDRA
Last Name:KREPPEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HOPPE-SEYLER-STRASSE 3
Mailing Address - Street 2:
Mailing Address - City:TUEBINGEN
Mailing Address - State:GERMANY
Mailing Address - Zip Code:72076
Mailing Address - Country:DE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3722 SOUTH HARLEM AVENUE MACNEAL CENTER FOR INTERNAL ME
Practice Address - Street 2:SUITE LL34
Practice Address - City:RIVERSIDE
Practice Address - State:IL
Practice Address - Zip Code:60546
Practice Address - Country:US
Practice Address - Phone:708-783-6566
Practice Address - Fax:708-783-6567
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
125-073410390200000X
390200000X
IL125073410207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program