Ryan Diederich, MD is a medicare enrolled "Surgery - Plastic And Reconstructive Surgery" physician in Glen Carbon, Illinois. His current practice location is
4955 S State Route 159 Ste 1, Glen Carbon, Illinois. You can reach out to his office (for appointments etc.) via phone at
(618) 288-7855.
Ryan Diederich is licensed to practice in Illinois (license number 125-050203) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1942422498.
Physician's Profile
Full Name | Ryan Diederich |
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Gender | Male |
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Speciality | |
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Experience | Years |
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Location | 4955 S State Route 159 Ste 1, Glen Carbon, Illinois |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Ryan Diederich attended and graduated from in
NPI Data:
- NPI Number: 1942422498
- Provider Enumeration Date: 05/03/2007
- Last Update Date: 08/21/2024
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Ryan Diederich such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1942422498 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2086S0122X | Surgery - Plastic And Reconstructive Surgery | 125-050203 (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. Ryan Diederich 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 |
Ryan Diederich, MD 4955 S State Route 159 Ste 1, Glen Carbon, IL 62034-1907 Ph: (618) 288-7855 | Ryan Diederich, MD 4955 S State Route 159 Ste 1, Glen Carbon, IL 62034-1907 Ph: (618) 288-7855 |
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