NPIMap

George Joseph Dirkers, M.D.

Individual provider Active NPI Internal Medicine Physician · Wood River, IL

NPI 1598880908 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1598880908
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
Practice address
325 Madison Ave
Wood River, IL 62095-2010
Phone
(618) 251-5202
Fax
(618) 251-5118
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-073051ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Occupational Medicine LTD. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X IL Yes

Addresses

Primary practice location

325 Madison Ave
Wood River, IL 62095-2010

Mailing address

325 Madison Ave
Wood River, IL 62095-2010
Phone (618) 251-5202

Other providers in Wood River, IL

All providers in Wood River, IL · Internal Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.