Richardson, Audrey C
Richardson, Audrey C is an individual health care provider with primary practice located at 1800 N Main St , Wheaton IL 60187-3112. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Richardson, Audrey C can be contacted via phone (630) 614-4960.Contact Information
Primary practice address
1800 N Main St
Wheaton IL 60187-3112
Phone: (630) 614-4960
Fax: (630) 682-3727
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 125043627 | Illinois |
Profile Details
| NPI number | 1326031196 |
|---|---|
| LBN Legal business name | Richardson, Audrey C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 26th, 2005 |
| Last updated | Apr 9th, 2014 - about 10 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 | 1326031196 | NPPES |
| Illinois | Other | P01245139 | MEDICARE RAILROAD (INDIVIDUAL) |
| Illinois | MEDICAID | 125043627 | MEDICARE RAILROAD (INDIVIDUAL) |
| Illinois | Other | CE8792 | MEDICARE RAILROAD (INDIVIDUAL) |
| Illinois | Other | 036114931 | MEDICARE RAILROAD (INDIVIDUAL) |
| Illinois | Other | 920540 | MEDICARE RAILROAD (INDIVIDUAL) |
| Illinois | MEDICAID | 4301086494 | MEDICARE RAILROAD (INDIVIDUAL) |
| Illinois | Other | F400100134 | MEDICARE RAILROAD (INDIVIDUAL) |
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