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NPI Code Detail

MEDICARE: DR. LORI M RILEY MD

MEDICARE:  DR. LORI M RILEY  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
1207Q00000XFamily Medicine PhysicianIL

General Provider Information

NPI Number : 1629160965
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LORI M RILEY MD
Provider Business Mailing Address
First Line : 7244 S PAXTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60649-2520
Country : US
Telephone Number : 773-493-3887
Fax Number : 773-493-3105
Provider Business Practice Location Address
First Line : 6020 S HALSTED ST
Second Line :
City : CHICAGO
State : IL
Zip : 60621-2112
Country : US
Telephone Number : 773-488-9608
Fax Number : 773-488-9605
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2006
Last Update Date : 11/08/2007

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Directions to “ DR. LORI M RILEY MD” Practice Location

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