Individual
RICHARD ALLAN BLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1160 N GREEN BAY RD, LAKE FOREST, IL 60045-1104
(847) 234-5296
Mailing address
1160 N GREEN BAY RD, LAKE FOREST, IL 60045-1104
(847) 234-5296
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022770
—
OR
Enumeration date
04/25/2006
Last updated
01/02/2019
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