Dietrich, Gina L.

Dietrich, Gina L. is an individual health care provider with primary practice located at 927 Broadway St Suite 220, Quincy IL 62301-2719. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Dietrich, Gina L. can be contacted via phone (217) 224-6423.

Contact Information

Primary practice address
927 Broadway St Suite 220 Quincy IL 62301-2719
Phone: (217) 224-6423
Fax: (217) 223-9172
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 2017011099 Missouri
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 036106243 Illinois

Profile Details

NPI number 1184648974
LBN Legal business name Dietrich, Gina L.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated May 15th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184648974 NPPES
Illinois MEDICAID 036106243
Illinois Other 077595

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