Richard W Twanow, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036090695 Issued in IL

Practice address

1302 N Greenwood St
Spring Valley, IL 61362-1576

Phone

(815) 663-5511

Fax

(815) 663-1528

NPI assigned

Aug 22, 2006

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2008.

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219363200000",
    "number": "1366558199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E 1ST ST",
            "city": "SPRING VALLEY",
            "state": "IL",
            "postal_code": "613621512",
            "telephone_number": "815-663-5511",
            "fax_number": "815-663-1528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 N GREENWOOD ST",
            "city": "SPRING VALLEY",
            "state": "IL",
            "postal_code": "613621576",
            "telephone_number": "815-663-5511",
            "fax_number": "815-663-1528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWANOW",
        "first_name": "RICHARD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2008-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036090695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090695",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2008; 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.