Individual
DR. RICHARD F WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2301 E 93RD ST, SUITE 110, CHICAGO, IL 60617-3913
(773) 731-2982
(773) 731-3328
Mailing address
122 E COLLEGE AVE, APPLETON, WI 54911-5794
(920) 996-3264
(920) 830-5910
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036078470
IL
207RH0000X
Hematology (Internal Medicine) Physician
036078470
IL
207RH0003X
Hematology & Oncology Physician
18369
WI
207RX0202X
Medical Oncology Physician
Primary
036078470
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001634652
BCBS - IL
IL
05
—
036078470
—
IL
01
—
1013981349
NPI - INDIVIDUAL
IL
01
—
1376505065
NPI - GROUP ( CMGI )
—
01
—
210946
MEDICARE PROVIDER #
IL
01
—
P00191109
RAILROAD - IL
IL
Enumeration date
02/14/2006
Last updated
07/18/2019
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