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NPI Code Detail

MEDICARE: DR. RICHARD MARK VOLDEN PH.D.

MEDICARE:  DR. RICHARD MARK VOLDEN  PH.D.
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
1103TC0700XClinical PsychologistIL

General Provider Information

NPI Number : 1881611523
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD MARK VOLDEN PH.D.
Provider Business Mailing Address
First Line : 655 W IRVING PARK RD
Second Line : SUITE 201
City : CHICAGO
State : IL
Zip : 60613-3123
Country : US
Telephone Number : 773-244-2812
Fax Number : 773-989-0790
Provider Business Practice Location Address
First Line : 655 W IRVING PARK RD
Second Line : SUITE 201
City : CHICAGO
State : IL
Zip : 60613-3123
Country : US
Telephone Number : 773-244-2812
Fax Number : 773-989-0790
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 07/08/2007

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