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Individual

BENJAMIN RIEGLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1304 FRANKLIN AVE STE 380, NORMAL, IL 61761-3558
(309) 268-5130
(309) 268-5784
Mailing address
611 W. PARK ST, FAPC, URBANA, IL 61801

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036156956
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
833230
MEDICARE GROUP #
Enumeration date
08/24/2010
Last updated
02/15/2024
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