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General NPI Number Information
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NPI Number | 1982168407
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Entity Type | Organization
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Legal Business Name | RICHARDSON PSYCHIATRIC
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Dates
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Enumeration Date | 01/29/2019
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Last Update Date | 01/29/2019
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Provider Practice Location Address
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Address Line | 3660 N LAKE SHORE DR STE 201
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City | CHICAGO
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State | IL
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Zip | 60613-5302
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Country | US
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Telephone | 773-599-9246
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 S EAST END AVE APT 8B
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City | CHICAGO
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State | IL
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Zip | 60615-3173
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Country | US
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Telephone | 773-732-6427
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | DR. ANDREW D RICHARDSON
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Credential | DNP
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Telephone | 773-732-6427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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