MEDICARE: JUDITH ELEN RITHOLZ 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
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	4301084838	MI
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	01074611A	IN
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	35134274	OH
4	207RP1001X	Pulmonary Disease Physician	01074611A	IN
5	207RP1001X	Pulmonary Disease Physician	036087847	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00874060	OTHER	MI	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	11011-1057-1	OTHER	MI	BLUE CROSS PIN
4	1538397120	OTHER	MI	NPI- GROUP
6	270381199	OTHER	MI	TAX ID
7	000001009771	OTHER	IN	ANTHEM PROVIDER NUMBER

General Provider Information

NPI Number	:	1043247042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH ELEN RITHOLZ MD

Provider Business Mailing Address
First Line	:	2754 N HAMPDEN CT APT 1906
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-4837
Country	:	US
Telephone Number	:	312-618-4369
Fax Number	:

Provider Business Practice Location Address
First Line	:	2754 N HAMPDEN CT APT 1906
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-4837
Country	:	US
Telephone Number	:	312-618-4369
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	03/07/2023

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