Burgess, Richard Ely

Burgess, Richard Ely is an individual health care provider with primary practice located at 1890 Silver Cross Blvd , New Lenox IL 60451. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Vascular Neurology. Allopathic & Osteopathic Physicians / Vascular Neurology is his primary health care specialty. Burgess, Richard Ely can be contacted via phone (815) 723-4387.

Contact Information

Primary practice address
1890 Silver Cross Blvd New Lenox IL 60451
Phone: (815) 723-4387
Fax: (815) 723-4634
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 35.098756 Ohio
Allopathic & Osteopathic Physicians / Vascular Neurology 2084V0102X D63053 Maryland
Allopathic & Osteopathic Physicians / Vascular Neurology 2084V0102X MD035372 District of Columbia
Allopathic & Osteopathic Physicians / Vascular Neurology 2084V0102X 036133825 Illinois

Profile Details

NPI number 1649340530
LBN Legal business name Burgess, Richard Ely
Credentials M.D., PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2006
Last updated Jun 21st, 2021 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649340530 NPPES
Ohio MEDICAID 0319247
Ohio MEDICAID 036133825

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