Individual provider Active NPI

Richard M Forster

  • Anesthesiology Physician
  • St Charles, IL
National Provider Identifier
1073529855
Registry record updated Mar 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
336025170 Issued in IL
Practice address
2210 Dean St
St Charles, IL 60175-1066
Phone
(630) 584-9800
Fax
(630) 584-9805
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 336025170 IL Primary

Addresses

Primary practice location

2210 Dean St
St Charles, IL 60175-1066

Mailing address

2320 Dean St Ste 103
St Charles, IL 60175-1068
Phone (630) 377-0106

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

LicenseStateTypeSpecialty
336025170ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Ambulatory Surgery Center, LP Current Accepting new patients

Locations

2210 Dean St
St Charles, IL 60175
Phone (630) 443-3397

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235952000000",
    "number": "1073529855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 DEAN ST STE 103",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601751068",
            "telephone_number": "630-377-0106",
            "fax_number": "630-377-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 DEAN ST",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601751066",
            "telephone_number": "630-584-9800",
            "fax_number": "630-584-9805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSTER",
        "first_name": "RICHARD",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2009-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "336025170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.