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General NPI Number Information
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NPI Number | 1710045786
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Entity Type | Individual
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Provider Name | RICHARD A. HERBERT M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 120 OAKBROOK CTR SUITE 711
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City | OAK BROOK
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State | IL
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Zip | 60523-1806
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Country | US
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Telephone | 630-606-1820
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Fax | 708-447-7693
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Provider Business Mailing Address
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Address Line | 396 SELBORNE RD
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City | RIVERSIDE
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State | IL
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Zip | 60546-1668
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Country | US
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Telephone | 708-447-7689
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Fax | 708-447-7693
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | IL
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