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JONATHAN JACOB DIETRICH MD
NPI 1073216131
Internal Medicine in Chicago, IL

Active since March 27, 2023PECOS Enrolled
3134 N CLARK ST, CHICAGO, IL 60657(312) 766-4949 Get Directions Write a Review

NPPES record last updated: June 21, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 21, 2023, Mar 27, 2023 (2 updates tracked since 2023).

About Jonathan Jacob Dietrich Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JONATHAN JACOB DIETRICH MD (NPI 1073216131) is an individual internal medicine provider in Chicago, Illinois, licensed in Illinois (125081580) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073216131
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJONATHAN JACOB DIETRICHCredential: MD
Location Address3134 N CLARK STChicago, IL 60657-4414
Mailing Address3134 N Clark StChicago, IL 60657-4414
Phone(312) 766-4949
Sole ProprietorNo
Enumeration DateMarch 27, 2023
Last NPPES UpdateJune 21, 20232 updates tracked since enumeration
NPPES CertifiedJune 21, 2023
✔ NPI 1073216131 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 125081580
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3134 N CLARK ST, Chicago, IL 60657
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jonathan Jacob Dietrich Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60657 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SORIN C DANCIU M.D.
Internal Medicine (Cardiovascular Disease)
3134 N CLARK ST
CHICAGO, IL 60657
Cook County (773) 880-9722
PARITA BHALODIA MD
Internal Medicine
3134 N CLARK ST
CHICAGO, IL 60657
Cook County (312) 766-4949
MRS. GLOWEN JANICA GOROSPE MEI MSN, APRN, ACNPC-AG
Nurse Practitioner
3134 N CLARK ST
CHICAGO, IL 60657
Cook County (312) 766-4949
CHRISTOPHER YAO
Internal Medicine
3134 N CLARK ST
CHICAGO, IL 60657
Cook County (312) 766-4949
PEDRO ANDRES GONZALEZ MARTINEZ MD
Internal Medicine (Cardiovascular Disease)
3134 N CLARK ST
CHICAGO, IL 60657
Cook County (312) 766-4949
LUBNA HANIF MD
Internal Medicine
3134 N CLARK ST
CHICAGO, IL 60657
Cook County (312) 766-4949
ABAAN MERCHANT
Internal Medicine
3134 N CLARK ST
CHICAGO, IL 60657
Cook County (312) 766-4949
GUILLERMO REYES MARTINEZ MD
Internal Medicine
3134 N CLARK ST
CHICAGO, IL 60657
Cook County (312) 766-4949

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Dietrich's NPI number?

The NPI number for Jonathan Dietrich is 1073216131. It was assigned to this individual provider in the NPPES registry on March 27, 2023.

Where is Jonathan Dietrich located?

Jonathan Dietrich practices at 3134 N Clark St, Chicago, IL 60657. The listed phone number is (312) 766-4949.

What is Jonathan Dietrich's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jonathan Dietrich enrolled in Medicare?

Yes. Jonathan Dietrich is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jonathan Dietrich was last updated on June 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.