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Richardson Psychiatric

Nurse Practitioner, Primary Care in Chicago, IL. Organization (NPI-2).

NPI number1982168407
StatusActive
Last updated in NPPESJan 29, 2019

Details

NPI
1982168407
Entity type
Organization (NPI-2)
Legal business name
Richardson Psychiatric
Organization subpart
No
Enumeration date
Jan 29, 2019
Last updated
Jan 29, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP2300X Nurse Practitioner, Primary Care––Yes
363LP0808X Nurse Practitioner, Psych/Mental Health––

Practice location

3660 N Lake Shore Dr Ste 201
Chicago, IL 60613-5302

Phone 773-599-9246

Mailing address

5000 S East End Ave Apt 8b
Chicago, IL 60615-3173

Phone 773-732-6427

Authorized official

Andrew D Richardson
Nurse Practitioner
7737326427

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