Richard D Penn, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

036047712 Issued in IL

Practice address

4950 S Chicago Beach Dr
Chicago, IL 60615-3204

Phone

(773) 947-9829

NPI assigned

Dec 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1174688907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 S CHICAGO BEACH DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606153204",
            "telephone_number": "773-947-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 S CHICAGO BEACH DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606153204",
            "telephone_number": "773-947-9829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "RICHARD",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036047712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036047712",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley E Penkala, MS, OTR/L
• Kate Penkethman
• Lauren Penman
• Emma Penn
• Judith M Penn
• Casey Pennel, P.A.
• Rebecca Pennel, MS, CF-SLP
• Dawn Catherine Penney, DO
• Claire Pennington
• Jordan Laine Pennington

• Neurological Surgery Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Neurological Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; 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.