Richard M Allen, M.D.
Individual provider Active NPI Specialist · Libertyville, IL
NPI 1609948124 · NPPES record last updated Oct 29, 2012
Key facts
- NPI
- 1609948124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 036067062 (IL)
- Practice address
- 890 Garfield Ave
200
Libertyville, IL 60048-4723 - Phone
- (847) 549-1818
- Fax
- (847) 680-1573
- NPI assigned
- Nov 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036067062 | IL | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| OB/Gyne Associates of Lake County, S.C. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 036067062 | IL | Yes |
Addresses
Primary practice location
890 Garfield Ave
200
Libertyville, IL 60048-4723
Mailing address
890 Garfield Ave
200
Libertyville, IL 60048-4723
Phone (847) 549-1818
Other providers in Libertyville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.