Odonnell, Richard E

Odonnell, Richard E is an individual health care provider with primary practice located at 3927 W 95Th Street , Evergreen Park IL 60805. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Odonnell, Richard E can be contacted via phone (708) 952-4566.

Contact Information

Primary practice address
3927 W 95Th Street Evergreen Park IL 60805
Fax: (708) 952-4568
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X Illinois

Profile Details

NPI number 1184600207
LBN Legal business name Odonnell, Richard E
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 20th, 2005
Last updated Jul 8th, 2007 - about 17 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 1184600207 NPPES
Illinois Other 01622829 BLUE SHIELD

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