Individual
ANDREW RAY RIFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
374 E GRAND AVE # 6740, CARBONDALE, IL 62901-3962
(618) 453-3311
(618) 453-4449
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-8000
(844) 470-2486
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-112145
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-112145
—
IL
01
—
036112145
IDPA FEE FOR SERVICE
IL
01
—
080113710
UNITED HEALTHCARE RR MEDI
IL
01
—
108735
HEALTH ALLIANCE
IL
01
—
613392200
DOL FECA
IL
01
—
614260006
MEDICARE PART B
IL
01
—
717084
HEALTHLINK
IL
01
—
I33595
TRICARE
IL
Enumeration date
07/13/2005
Last updated
05/10/2024
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