Individual
ETHAN RICHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
27650 FERRY RD STE 100, WARRENVILLE, IL 60555-3846
(630) 225-2663
(630) 225-2399
Mailing address
27650 FERRY RD STE 100, WARRENVILLE, IL 60555-3846
(630) 225-2663
(630) 225-2399
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085011609
IL
363A00000X
Physician Assistant
50.007619RX
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/24/2022
Last updated
06/10/2026
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