Anderson, Richard
Anderson, Richard is an individual health care provider with primary practice located at 1001 Main Street 3Rd Floor, Peoria IL 61606-2037. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery). Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Anderson, Richard can be contacted via phone (309) 495-0200.Contact Information
Primary practice address
1001 Main Street 3Rd Floor
Peoria IL 61606-2037
Phone: (309) 495-0200
Fax: (309) 676-6545
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 036095602 | Illinois |
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 036095602 | Illinois |
Profile Details
| NPI number | 1699703892 |
|---|---|
| LBN Legal business name | Anderson, Richard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2006 |
| Last updated | May 29th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699703892 | NPPES |
| Illinois | MEDICAID | 036095602-1 | |
| Illinois | Other | 7215166 | |
| Illinois | Other | 020046522 |
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