Individual
RICHARD FLOYD MULTACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
20303 CRAWFORD AVE, SUITE LL 1, OLYMPIA FIELDS, IL 60461-1073
(708) 898-1858
(708) 898-1860
Mailing address
20303 S CRAWFORD AVENUE, SUITE LL 1, OLYMPIA FIELDS, IL 60461-1030
(708) 898-1858
(708) 898-1860
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036059149
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036059149
—
IL
01
—
180014262
R/R MEDICARE
—
Enumeration date
08/19/2006
Last updated
02/28/2013
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