MEDICARE: RICHARD B WARSHELL MD

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	207P00000X	Emergency Medicine Physician	41520	WI
2	207P00000X	Emergency Medicine Physician	036-107962	IL

General Provider Information

NPI Number	:	1336119163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD B WARSHELL MD

Provider Business Mailing Address
First Line	:	1333 BUTTERFIELD RD
Second Line	:	STE 130
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-5641
Country	:	US
Telephone Number	:	630-371-0133
Fax Number	:	630-371-0138

Provider Business Practice Location Address
First Line	:	2839 W MORSE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-2929
Country	:	US
Telephone Number	:	773-973-2768
Fax Number	:

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

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	01/05/2021

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