MEDICARE: DR. RICHARD ARTHUR ARRANDT DC

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	111N00000X	Chiropractor	038007396	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1606342	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1710092143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD ARTHUR ARRANDT DC

Provider Business Mailing Address
First Line	:	2611 N HERMITAGE AVE APT 320
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-9301
Country	:	US
Telephone Number	:	312-919-8700
Fax Number	:

Provider Business Practice Location Address
First Line	:	2611 N HERMITAGE AVE APT 320
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-9301
Country	:	US
Telephone Number	:	312-919-8700
Fax Number	:

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

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	08/11/2022

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