Provider Demographics
NPI:1508976747
Name:GEIGER, RICHARD H JR (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:H
Last Name:GEIGER
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10743 165TH ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-8713
Mailing Address - Country:US
Mailing Address - Phone:708-479-8888
Mailing Address - Fax:708-675-1177
Practice Address - Street 1:10743 WEST 165TH STREET
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467
Practice Address - Country:US
Practice Address - Phone:708-460-9600
Practice Address - Fax:708-675-1177
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILIL036071213207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0009925485OtherBLUE CROSS & BLUE SHIELD
IL778500Medicare UPIN
IL216045Medicare UPIN