Individual
JOHN PAUL RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
11104 PARKVIEW CIRCLE DR STE 330, FORT WAYNE, IN 46845-1674
(260) 494-3484
(260) 969-0188
Mailing address
120 W 22ND ST STE 200, OAK BROOK, IL 60523-1563
(630) 575-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000373
IN
Other
Enumeration date
06/26/2006
Last updated
11/18/2022
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