Ryan Diederich, MD
Ryan Diederich, MD is a Plastic and Reconstructive Surgery Physician in Glen Carbon, Illinois. Licensed in Illinois. Registered with an NPI since 2007.
- Licensed in
- IL
- In the registry since
- 2007
What do these letters mean?
- MD — Doctor of Medicine
- A physician who completed allopathic medical school.
Practice location Address checks out
4955 S State Route 159 Ste 1Glen Carbon, IL 62034-1907
Phone: (618) 288-7855
Fax: (618) 288-7866
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Specialties & licences
| Plastic and Reconstructive Surgery Physician (primary) | Taxonomy 2086S0122X · Licence 125-050203 (IL) |
|---|
Record details
| NPI number | 1942422498 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MD |
| Sole proprietor | No |
| NPI enumerated | May 3, 2007 |
| Last updated in NPPES | August 21, 2024 |
| Certification date | August 21, 2024 |
| Mailing address | 4955 S State Route 159 Ste 1, Glen Carbon, IL 62034-1907 |
Other providers in Glen Carbon
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Ryan S. Diederich, MD PC
4955 S State Route 159 # 1, Glen Carbon, IL 62034-1907 · (618) 288-7855