Search › Illinois › 152W00000X
Nathan Dieckow, O.D
NPI 1841423753 · on the registry since 2009
Practice
- Address
- 1115 N Henderson St
Galesburg, IL 61401 - Phone
- (309) 343-1107
- Fax
- (309) 343-1306
- Organisation at this address
- Ava Rose Eyecare Ltd
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Also registered as
- 152W00000X
- Licence states on file
- MO, IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2015-07-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois