MEDICARE: DR. RICHARD ALAN STRNAD DO10

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician		IL

General Provider Information

NPI Number	:	1235197385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD ALAN STRNAD DO10

Provider Business Mailing Address
First Line	:	6105 CLUB HOUSE CT
Second Line	:
City	:	GURNEE
State	:	IL
Zip	:	60031-4723
Country	:	US
Telephone Number	:	847-816-7014
Fax Number	:	847-688-2512

Provider Business Practice Location Address
First Line	:	2410 SAMPSON ST
Second Line	:
City	:	GREAT LAKES
State	:	IL
Zip	:	60088-2942
Country	:	US
Telephone Number	:	847-688-5556
Fax Number	:	847-688-2512

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	07/08/2007

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