Ryan S. Diederich, MD PC
NPI 1639817182 · Plastic and Reconstructive Surgery Physician · Glen Carbon, IL
Ryan S. Diederich, MD PC is a Plastic and Reconstructive Surgery Physician organization in Glen Carbon, IL (NPI 1639817182).
Provider details
- NPI number
- 1639817182
- Entity type
- Organization
- Primary specialty
- Plastic and Reconstructive Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ryan Diederich, Owner(618) 288-7855
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Midamerica Plastic Surgery
Registry dates
- Enumerated
- 2022-05-24
- Last updated
- 2022-05-24
- Certified
- 2022-05-24
Frequently asked questions
- What is Ryan S. Diederich, MD PC's NPI number?
- Ryan S. Diederich, MD PC's National Provider Identifier (NPI) is 1639817182, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ryan S. Diederich, MD PC?
- Ryan S. Diederich, MD PC is classified in the NPPES registry as Plastic and Reconstructive Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Ryan S. Diederich, MD PC located?
- Ryan S. Diederich, MD PC's practice location on file with NPPES is 4955 S State Route 159 # 1, Glen Carbon, IL 62034-1907.
- What is Ryan S. Diederich, MD PC's phone number?
- The practice phone number listed in the NPPES registry for Ryan S. Diederich, MD PC is (618) 288-7855.
- Who is the authorized official for Ryan S. Diederich, MD PC?
- The authorized official listed on Ryan S. Diederich, MD PC's NPPES record is Ryan Diederich, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ryan S. Diederich, MD PC's NPI active?
- Yes — Ryan S. Diederich, MD PC's NPI (1639817182) is active in the NPPES registry as of the last update on 2022-05-24.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.