Provider Demographics
NPI:1487830717
Name:RICHARD J POWERS, DPM
Entity Type:Organization
Organization Name:RICHARD J POWERS, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:708-269-7244
Mailing Address - Street 1:1804 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-3910
Mailing Address - Country:US
Mailing Address - Phone:847-398-0939
Mailing Address - Fax:847-398-0973
Practice Address - Street 1:434 E PALATINE RD
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-5119
Practice Address - Country:US
Practice Address - Phone:847-398-0939
Practice Address - Fax:847-398-0973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016003935332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1041310001Medicare NSC