# RICHARD N SHATZ MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871766717
- **Authorized official:** DR. RICHARD NELSON SHATZ M.D. (OWNER)
- **Authorized official phone:** (217) 228-1312

## Contact information

- **Practice address:** 1135 BROADWAY ST, QUINCY, IL 62301-2809
- **Practice address phone:** (217) 228-1312
- **Practice address fax:** (217) 228-1316
- **Mailing address:** 1135 BROADWAY ST, QUINCY, IL 62301-2809
- **Mailing address phone:** (217) 228-1312
- **Mailing address fax:** (217) 228-1316

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/11/2008
- **Last updated:** 04/11/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200001410 | — | MO |
| 05 | — | 36107867 | — | IL |