Raymond Dieter Jr, MD is a medicare enrolled "Thoracic Surgery (cardiothoracic Vascular Surgery)" physician in Glen Ellyn, Illinois. His current practice location is
430 Pennsylvania Ave, Glen Ellyn, Illinois. You can reach out to his office (for appointments etc.) via phone at
(630) 469-9200.
Raymond Dieter Jr is licensed to practice in Illinois (license number 036037486) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1285609776.
Physician's Profile
Full Name | Raymond Dieter Jr |
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Gender | Male |
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Speciality | Thoracic Surgery (cardiothoracic Vascular Surgery) |
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Location | 430 Pennsylvania Ave, Glen Ellyn, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1285609776
- Provider Enumeration Date: 02/20/2006
- Last Update Date: 01/20/2011
Medicare PECOS Information:
- PECOS PAC ID: 7012819642
- Enrollment ID: I20160414001328
Medical Identifiers
Medical identifiers for Raymond Dieter Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1285609776 | NPI | - | NPPES |
036037486 | Medicaid | IL | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 036037486 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Raymond Dieter Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Raymond Dieter Jr, MD 1860 Paysphere Cir, Chicago, IL 60674-0018 Ph: (630) 469-9200 | Raymond Dieter Jr, MD 430 Pennsylvania Ave, Glen Ellyn, IL 60137-4464 Ph: (630) 469-9200 |
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