Active NPI
Robert R Richardson, M.D.
- Neurological Surgery Physician
- Geneva, IL
National Provider Identifier
1033105093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 036-044156
- Practice address
- 351 Delnor
Geneva, IL 60134 - Phone
- (630) 933-4056
- Fax
- (630) 933-4057
- NPI assigned
- Sep 26, 2005
- Last updated
- Jun 26, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 036-044156 | IL | Primary |
Addresses
Primary practice location
351 Delnor
Geneva, IL 60134
Mailing address
25 N Winfield Rd
Winfield, IL 60190-1295
Phone (630) 933-4056
Other practice location 1
1551 Bond St
Suite 143
Naperville, IL 60563-0137
Phone (630) 983-7100
Other practice location 2
1551 Bond St
Suite 143
Naperville, IL 60563-0137
Phone (630) 983-7100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036044156 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-044156 | IL | MD | Neurological Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529971200000",
"number": "1033105093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 N WINFIELD RD",
"city": "WINFIELD",
"state": "IL",
"postal_code": "601901295",
"telephone_number": "630-933-4056",
"fax_number": "630-933-4057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "351 DELNOR",
"city": "GENEVA",
"state": "IL",
"postal_code": "60134",
"telephone_number": "630-933-4056",
"fax_number": "630-933-4057"
}
],
"practiceLocations": [
{
"address_1": "1551 Bond St",
"address_2": "Suite 143",
"address_purpose": "LOCATION",
"city": "Naperville",
"state": "IL",
"postal_code": "605630137",
"country_code": "US",
"telephone_number": "630-983-7100",
"fax_number": "630-983-6331",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1551 Bond St",
"address_2": "Suite 143",
"address_purpose": "LOCATION",
"city": "Naperville",
"state": "IL",
"postal_code": "605630137",
"country_code": "US",
"telephone_number": "630-983-7100",
"fax_number": "630-983-6331",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RICHARDSON",
"first_name": "ROBERT",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-26",
"last_updated": "2018-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "IL",
"license": "036-044156",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036044156",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Geneva, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.