Provider Demographics
NPI:1235460684
Name:DEMPSEY, RICHARD GEORGE (LPED)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:GEORGE
Last Name:DEMPSEY
Suffix:
Gender:M
Credentials:LPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N SANTA ROSA ST
Mailing Address - Street 2:APT 1008
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-3205
Mailing Address - Country:US
Mailing Address - Phone:312-343-5457
Mailing Address - Fax:312-533-4695
Practice Address - Street 1:345 E SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2654
Practice Address - Country:US
Practice Address - Phone:312-238-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-25
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL212000089222Z00000X
IL227001243225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist