Healthcare Provider Details

I. General information

NPI: 1770564122
Provider Name (Legal Business Name): RICHARD D FINEGOLD MD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 07/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 SCHILLER
ELMHURST IL
60126-2885
US

IV. Provider business mailing address

172 SCHILLER
ELMHURST IL
60126-2885
US

V. Phone/Fax

Practice location:
  • Phone: 331-221-9001
  • Fax: 331-221-3904
Mailing address:
  • Phone: 331-221-9000
  • Fax: 331-221-3904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036072555
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License Number036072555
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: