Richard L Adis, M.D.
Individual provider Active NPI Obstetrics & Gynecology Physician · Highland Park, IL
NPI 1861411399 · NPPES record last updated Aug 15, 2013
Key facts
- NPI
- 1861411399
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 036047460 (IL)
- Practice address
- 767 Park Ave W
Suite 240
Highland Park, IL 60035-2400 - Phone
- (847) 432-1558
- Fax
- (847) 432-6981
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endeavor Health Medical Group | Obstetrics & Gynecology | Current | Accepting new patients |
| Northshore Women'S Health Associates, S.C. | Obstetrics & Gynecology | Past |
Accepting new patients |
Locations
9532 Eagle Way
Chicago, IL 60678
49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575
2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
767 Park Ave W
Ste 240
Highland Park, IL 60035
Phone (847) 432-1558
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 036047460 | IL | Yes |
Addresses
Primary practice location
767 Park Ave W
Suite 240
Highland Park, IL 60035-2400
Mailing address
767 Park Ave W
Suite 240
Highland Park, IL 60035-2400
Phone (847) 432-1558
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036047460 | Medicaid | IL |
Other providers in Highland Park, IL
- Whitney Amaris Abbott
- Wendy C Abrams
- Acucare Northshore Wellness
- Loren A Adelman
- Matthew Eric Adess
- Advanced Medicine Integration Group, L.P.
- Linda Advincula
- Eve Cooper Agin
- Ahtletico
- Sarah Ann Ahto
All providers in Highland Park, IL · Obstetrics & Gynecology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2013. 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.