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Individual

DR. RICHARD LICHTENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.S.

Contact information

Practice address
1 INGALLS DR, HARVEY, IL 60426-3558
(708) 331-7800
(708) 339-0695
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7339

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036082391
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036082391
IL
Enumeration date
04/07/2006
Last updated
06/13/2018
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