Individual
DR. RICHARD SEVERIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, PHD, CCS
Contact information
Practice address
1640 W ROOSEVELT RD, CHICAGO, IL 60608-1316
(312) 413-8043
Mailing address
1919 W TAYLOR ST # MC898, CHICAGO, IL 60612-7246
(312) 413-5228
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070021127
IL
2251C2600X
Cardiopulmonary Physical Therapist
Primary
070021127
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT023081
PENNSYLVANNIA PT LICENSE NUMBER
PA
Enumeration date
09/17/2013
Last updated
02/21/2024
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