Individual
RICHARD T EDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 N 1ST ST, SPRINGFIELD, IL 62702-3749
(217) 528-7541
(217) 525-0121
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
(217) 528-8962
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
036119111
IL
207VG0400X
Gynecology Physician
Primary
036119111
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036119111
—
IL
Enumeration date
06/25/2006
Last updated
03/26/2024
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