Provider Demographics
NPI:1942723366
Name:DITTMAR, DANIELA CRISTINA (MD)
Entity type:Individual
Prefix:DR
First Name:DANIELA
Middle Name:CRISTINA
Last Name:DITTMAR
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 1:1937 W 35TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60609-1206
Mailing Address - Country:US
Mailing Address - Phone:312-522-9827
Mailing Address - Fax:
Practice Address - Street 1:1937 W 35TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60609-1206
Practice Address - Country:US
Practice Address - Phone:773-523-8014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.150411207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine