Healthcare Provider Details

I. General information

NPI: 1982939872
Provider Name (Legal Business Name): RICHARD SHERMER MD SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2009
Last Update Date: 11/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5645 W ADDISON ST 248
CHICAGO IL
60634-4403
US

IV. Provider business mailing address

5645 W ADDISON ST 248
CHICAGO IL
60634-4403
US

V. Phone/Fax

Practice location:
  • Phone: 773-527-5071
  • Fax:
Mailing address:
  • Phone: 773-527-5071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD SHERMER
Title or Position: PRESIDENT
Credential: MD
Phone: 13126499247