Provider Demographics
NPI:1588661383
Name:DILGER, CHRISTOPHER R (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:R
Last Name:DILGER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W. 13TH ST.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-1883
Mailing Address - Country:US
Mailing Address - Phone:812-482-7441
Mailing Address - Fax:812-482-7444
Practice Address - Street 1:600 W. 13TH ST.
Practice Address - Street 2:SUITE 200
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-1883
Practice Address - Country:US
Practice Address - Phone:812-482-7441
Practice Address - Fax:812-482-7444
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10000653A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000556384OtherANTHEM
219120BINMedicare PIN
IN000000556384OtherANTHEM
IN219120BMedicare PIN
Q06134Medicare UPIN