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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

RYAN S. DIEDERICH, MD PC

Active Organization

RYAN S. DIEDERICH, MD PC is a Plastic and Reconstructive Surgery organization located in GLEN CARBON, Illinois. NPI 1639817182 is currently active in the NPPES registry. Verify at CMS.

Plastic and Reconstructive Surgery · GLEN CARBON, IL

Registration Details

NPI Number
1639817182
Provider Type
Organization
NPI Issued
May 24, 2022 (4.2435077263603 yrs)
Last Updated
May 24, 2022

Practice Information

Address
4955 S STATE ROUTE 159 # 1
GLEN CARBON, IL, 620341907
Browse IL providers · Browse ZIP 62034
Phone
6182887855
Fax
6182887866
Primary Specialty
Plastic and Reconstructive Surgery
2086S0122X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.