Individual provider Active NPI

Richard Kenneth Saffro, M.D.

  • Internal Medicine Physician
  • Highland Park, IL
National Provider Identifier
1366680977
Registry record updated Feb 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36-055151 Issued in IL
Practice address
1795 Edgewood Rd
Highland Park, IL 60035-3741
Phone
(847) 226-6770
Fax
(847) 831-2352
NPI assigned
Feb 4, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36-055151 IL Primary

Addresses

Primary practice location

1795 Edgewood Rd
Highland Park, IL 60035-3741

Mailing address

1795 Edgewood Rd
Highland Park, IL 60035-3741
Phone (847) 226-6770

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36-055151ILMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233705600000",
    "number": "1366680977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 EDGEWOOD RD",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353741",
            "telephone_number": "847-226-6770",
            "fax_number": "847-831-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 EDGEWOOD RD",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353741",
            "telephone_number": "847-226-6770",
            "fax_number": "847-831-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFFRO",
        "first_name": "RICHARD",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-04",
        "last_updated": "2009-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36-055151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.