Healthcare Provider Details

I. General information

NPI: 1164595146
Provider Name (Legal Business Name): RICHARD E HRDLICKA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 RANDALL RD 206
GENEVA IL
60134
US

IV. Provider business mailing address

302 RANDALL RD 206
GENEVA IL
60134
US

V. Phone/Fax

Practice location:
  • Phone: 630-232-1900
  • Fax: 630-232-7971
Mailing address:
  • Phone: 630-232-1900
  • Fax: 630-232-7971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: