MEDICARE: MR. RICHARD TODD DINEEN M.S.

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	170300000X	Genetic Counselor (M.S.)	246000038	IL

General Provider Information

NPI Number	:	1992920441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD TODD DINEEN M.S.

Provider Business Mailing Address
First Line	:	1725 W HARRISON ST STE 1118
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3845
Country	:	US
Telephone Number	:	312-563-4515
Fax Number	:	312-942-2380

Provider Business Practice Location Address
First Line	:	1520 W HARRISON ST FL 7
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-3106
Country	:	US
Telephone Number	:	312-942-4500
Fax Number	:	312-942-2380

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

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	07/08/2025

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