Provider Demographics
NPI:1114957495
Name:HUGHES, RICHARD JAMES (BSRT RDMS)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:JAMES
Last Name:HUGHES
Suffix:
Gender:M
Credentials:BSRT RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15342 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-4008
Mailing Address - Country:US
Mailing Address - Phone:708-349-7219
Mailing Address - Fax:
Practice Address - Street 1:15342 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-4008
Practice Address - Country:US
Practice Address - Phone:708-349-7219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2008-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL214872Medicare ID - Type UnspecifiedLOCALITY 016
IL214871Medicare ID - Type UnspecifiedLOCALITY 015