Individual
JAY MARTIN DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN, NP-C
Contact information
Practice address
2200 E WASHINGTON ST, BLOOMINGTON, IL 61701-4364
(309) 662-3311
Mailing address
206 BEACON CIR, BLOOMINGTON, IL 61704-1414
(309) 502-0379
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041446858
IL
363L00000X
Nurse Practitioner
209021931
IL
363LF0000X
Family Nurse Practitioner
Primary
041446858
IL
Other
Enumeration date
01/30/2021
Last updated
02/27/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us