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NPI Code Detail

MEDICARE: DR. RICHARD F WARREN MD

MEDICARE:  DR. RICHARD F WARREN  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician036078470IL
2207RH0000XHematology (Internal Medicine) Physician036078470IL
3207RH0003XHematology & Oncology Physician18369WI
4207RX0202XMedical Oncology Physician036078470IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3210946OTHERILMEDICARE PROVIDER #

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10001634652OTHERILBCBS - IL
21376505065OTHERNPI - GROUP ( CMGI )
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5P00191109OTHERILRAILROAD - IL
61013981349OTHERILNPI - INDIVIDUAL

General Provider Information

NPI Number : 1013981349
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD F WARREN MD
Provider Business Mailing Address
First Line : 122 E COLLEGE AVE
Second Line :
City : APPLETON
State : WI
Zip : 54911-5794
Country : US
Telephone Number : 920-996-3264
Fax Number : 920-830-5910
Provider Business Practice Location Address
First Line : 2301 E 93RD ST
Second Line : SUITE 110
City : CHICAGO
State : IL
Zip : 60617-3913
Country : US
Telephone Number : 773-731-2982
Fax Number : 773-731-3328
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2006
Last Update Date : 07/18/2019

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Directions to “ DR. RICHARD F WARREN MD” Practice Location

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