Individual
RICHARD M BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 N 8TH ST, SPRINGFIELD, IL 62701-1041
(217) 545-6099
(217) 545-0253
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-7578
(217) 545-1884
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036042867
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036042867
—
IL
Enumeration date
09/20/2005
Last updated
10/16/2020
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