Richards, Ken R

Richards, Ken R is an individual health care provider with primary practice located at 2320 E 93Rd St Trinity Hospital, Chicago IL 60617-3983. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Richards, Ken R can be contacted via phone (773) 324-0553.

Contact Information

Primary practice address
2320 E 93Rd St Trinity Hospital Chicago IL 60617-3983
Phone: (773) 324-0553
Fax: (773) 324-0553
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 0101233117 Virginia
Allopathic & Osteopathic Physicians / Surgery 208600000X 036-114696 Illinois

Profile Details

NPI number 1477545937
LBN Legal business name Richards, Ken R
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Dec 13th, 2012 - about 12 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 1477545937 NPPES
Virginia MEDICAID 007312881

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