Individual
JOSHUA RIEKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3050 MONTVALE DR STE A, SPRINGFIELD, IL 62704-6924
(217) 726-8096
Mailing address
2040 W ILES AVE STE C, SPRINGFIELD, IL 62704-4183
(217) 789-0668
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
125-051981
IL
2085R0202X
Diagnostic Radiology Physician
2012014547
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036123103
—
IL
05
—
209579408
—
MO
Enumeration date
05/01/2007
Last updated
06/29/2021
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