Basic Information
| Provider Information | |||||||||
| NPI: | 1699263632 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KREPPEL | ||||||||
| FirstName: | DIANA | ||||||||
| MiddleName: | ALEXANDRA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | HOPPE-SEYLER-STRASSE 3 | ||||||||
| Address2: | |||||||||
| City: | TUEBINGEN | ||||||||
| State: | GERMANY | ||||||||
| PostalCode: | 72076 | ||||||||
| CountryCode: | DE | ||||||||
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| Practice Location | |||||||||
| Address1: | 3722 SOUTH HARLEM AVENUE MACNEAL CENTER FOR INTERNAL ME | ||||||||
| Address2: | SUITE LL34 | ||||||||
| City: | RIVERSIDE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60546 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7087836566 | ||||||||
| FaxNumber: | 7087836567 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2018 | ||||||||
| LastUpdateDate: | 06/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 125-073410 | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 125073410 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.