Driessnack, Richard Paul

Driessnack, Richard Paul is an individual health care provider with primary practice located at 303 N William Kumpf Blvd , Peoria IL 61605-2507. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery, which is considered as his primary health care specialty. Driessnack, Richard Paul can be contacted via phone (309) 676-5546.

Contact Information

Primary practice address
303 N William Kumpf Blvd Peoria IL 61605-2507
Phone: (309) 676-5546
Fax: (309) 676-5045
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery 207XS0114X 36077466 Illinois

Profile Details

NPI number 1679573901
LBN Legal business name Driessnack, Richard Paul
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2005
Last updated Nov 2nd, 2010 - about 14 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 1679573901 NPPES
Illinois MEDICAID 36077466

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