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NPI Code Detail

MEDICARE: RICHARD MONAHAN DDS

MEDICARE:   RICHARD  MONAHAN  DDS
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
11223X0008XOral and Maxillofacial Radiology DentistryIL

General Provider Information

NPI Number : 1952438509
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD MONAHAN DDS
Provider Business Mailing Address
First Line : 2211 N OAK PARK AVE
Second Line : SHRINERS HOSPITAL FOR CHILDREN
City : CHICAGO
State : IL
Zip : 60707-3351
Country : US
Telephone Number : 773-622-5400
Fax Number : 773-385-5830
Provider Business Practice Location Address
First Line : 2211 N OAK PARK AVE
Second Line : SHRINERS HOSPITAL FOR CHILDREN
City : CHICAGO
State : IL
Zip : 60707-3351
Country : US
Telephone Number : 773-622-5400
Fax Number : 773-385-5830
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 07/08/2007

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