Healthcare Provider Details

I. General information

NPI: 1336119163
Provider Name (Legal Business Name): RICHARD B WARSHELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 W DEVON AVE STE 2
CHICAGO IL
60659-1200
US

IV. Provider business mailing address

2839 W MORSE AVE
CHICAGO IL
60645-2929
US

V. Phone/Fax

Practice location:
  • Phone: 872-293-6978
  • Fax:
Mailing address:
  • Phone: 773-814-3425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.107962
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: