MEDICARE: RICHARD ROBERT TROSPER

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	209.035117	IL

General Provider Information

NPI Number	:	1346181047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD ROBERT TROSPER

Provider Business Mailing Address
First Line	:	3941 W AINSLIE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3882
Country	:	US
Telephone Number	:	773-939-0296
Fax Number	:

Provider Business Practice Location Address
First Line	:	3941 W AINSLIE ST APT F
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-6177
Country	:	US
Telephone Number	:	773-939-0296
Fax Number	:

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

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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