Organization
SUBURBAN EMERGENCY PHYSICIANS GROUP, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES A RICHARDSON MD (OWNER)
(773) 363-1090
Entity
Organization
Contact information
Practice address
6836 S EUCLID AVE, CHICAGO, IL 60649-1510
(773) 363-1090
(773) 363-1091
Mailing address
6836 S EUCLID AVE, CHICAGO, IL 60649-1510
(773) 363-1090
(773) 363-1091
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC2148
RAILROAD MEDICARE
IL
Enumeration date
01/19/2006
Last updated
04/14/2008
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