Ryan Diederich, MD
Plastic Surgery · Glen Carbon, IL
UnclaimedMDNPI 1942422498
- Primary taxonomy
- 2086S0122X
- Enumerated
- 2007-05-03
- Practice location
- Glen Carbon, IL
- Last NPPES update
- 2024-08-21
State licenses
- IL · Physician · LICENSED PHYSICIAN AND SURGEONActivethrough 2029
- IL · Resident physician · TEMPORARY MEDICAL PERMITInactivethrough 2011
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.