| Bonita G Dietrich, | |
|
2900 N Knoxville Ave, Peoria, IL 61603-1748 | |
| (309) 688-3616 | |
| (309) 687-3370 |
| Full Name | Bonita G Dietrich |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 2900 N Knoxville Ave, Peoria, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386734689 | NPI | - | NPPES |
| 809840019 | Other | IL | MEDICARE INDIVIDUAL PTAN |
| CA4079 | Other | RR GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 041248649/209000680 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Bonita G Dietrich, 2900 N Knoxville Ave, Peoria, IL 61603-1748 Ph: (309) 688-3616 | Bonita G Dietrich, 2900 N Knoxville Ave, Peoria, IL 61603-1748 Ph: (309) 688-3616 |
Mr. Ryan Eugene Parnham, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 530 Ne Glen Oak Ave, Suite 108, Peoria, IL 61537 Phone: 309-624-8818 | |
Faye Yetton, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2015 W Austin Dr, Peoria, IL 61614 Phone: 309-256-0632 | |
Linda Schmidgall, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 420 Ne Glen Oak Ave, Suite 200, Peoria, IL 61603 Phone: 309-624-5100 Fax: 309-624-5569 | |
Sandra L. Peach, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 420 Ne Glen Oak Ave, Peoria, IL 61603 Phone: 309-655-2343 Fax: 309-655-3948 | |
Roxanne Mclaughlin, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8940 N Wood Sage Rd, Peoria, IL 61615 Phone: 309-243-3000 Fax: 309-243-3274 | |
Suzanne D Tietjen, BSN, NNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2974 | |
Brittany N Hemmele, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 8600 N State Route 91, Peoria, IL 61615 Phone: 309-683-5050 Fax: 309-683-5335 |