Bonita G. Dietrich
Nurse Practitioner
2900 N Knoxville Ave, Peoria
Illinois, 61603-1748
309-688-3616
May or may not accept Medicare Nurse Anesthetist in Peoria, Illinois.Bonita G. Dietrich is a Peoria, Illinois based nurse practitioner. Active license number of Bonita G. Dietrich is 041248649/209000680 in Illinois. Her current practice location is 2900 N Knoxville Ave, Peoria. Patients can reach her at 309-688-3616 or can fax her at 309-687-3370 and her NPI number (Unique professional ID assigned by NPPES) is 1386734689.
Bonita G. Dietrich has completed additional training beyond basic nursing education and provides primary health care services in accordance with state nurse practice laws or statutes. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans.
Complete Profile:
Bonita G. Dietrich speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Bonita G. Dietrich |
| Specialization: | Nurse Practitioner (NP) |
| Gender: | Female |
| Practice Address: | 2900 N Knoxville Ave, Peoria, Illinois, 61603-1748 |
| Phone: | 309-688-3616 |
| Fax: | 309-687-3370 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1386734689 |
| NPI Enumeration Date: | 15 Oct, 2006 |
| NPI Last Update On: | 05 Aug, 2009 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Bonita G. Dietrich are as mentioned below.
| License Number | Specialization | State | Status | |
| 041248649/209000680 | | Illinois | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Bonita G. Dietrich such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 809840019 | Other | Illinois | MEDICARE INDIVIDUAL PTAN |
| CA4079 | Other | | RR GROUP # |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Bonita G. Dietrich 2900 N Knoxville Ave, Peoria, Illinois |
| Zip: | 61603-1748 |
| Phone Number: | 309-688-3616 |
| Fax Number: | 309-687-3370 |
Patients can reach Bonita G. Dietrich at
2900 N Knoxville Ave, Peoria, Illinois or can
call to book an appointment on 309-688-3616.
Comments/ Reviews:
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.