Individual
DR. KEN R RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2320 E 93RD ST, TRINITY HOSPITAL, CHICAGO, IL 60617-3983
(773) 324-0553
(773) 324-0553
Mailing address
2320 E 93RD STREET, 1, CHICAGO, IL 60616-5256
(773) 967-4130
(773) 967-4138
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101233117
VA
208600000X
Surgery Physician
Primary
036-114696
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007312881
—
VA
Enumeration date
08/19/2005
Last updated
12/13/2012
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