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General NPI Number Information
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NPI Number | 1811228174
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Entity Type | Individual
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Provider Name | DR. TERRI RICHMOND
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Gender | Female
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Dates
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Enumeration Date | 01/26/2010
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 2800 S CALIFORNIA AVE
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City | CHICAGO
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State | IL
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Zip | 60608-5107
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Country | US
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Telephone | --
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 S CALIFORNIA AVE
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City | CHICAGO
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State | IL
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Zip | 60608-5107
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Country | US
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Telephone |
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 20042295A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 159-000526
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 07100013
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License Number State | IL
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