Provider Demographics
NPI:1417591173
Name:RESCH, DIMI DAWN (NP)
Entity type:Individual
Prefix:
First Name:DIMI
Middle Name:DAWN
Last Name:RESCH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DIMI
Other - Middle Name:DAWN
Other - Last Name:JOLLIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:373 ROANOKE DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62221-5723
Mailing Address - Country:US
Mailing Address - Phone:618-322-8825
Mailing Address - Fax:
Practice Address - Street 1:373 ROANOKE DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62221-5723
Practice Address - Country:US
Practice Address - Phone:618-322-8825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209019681207Q00000X, 208000000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics