Provider Demographics
NPI:1578598652
Name:WRIGHT, RICHELE L (NP)
Entity Type:Individual
Prefix:
First Name:RICHELE
Middle Name:L
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:9731 LINCOLN PLAZA WAY UNIT 8
Mailing Address - Street 2:
Mailing Address - City:CEDAR LAKE
Mailing Address - State:IN
Mailing Address - Zip Code:46303-7916
Mailing Address - Country:US
Mailing Address - Phone:219-401-8968
Mailing Address - Fax:219-401-8981
Practice Address - Street 1:7531 S STONY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-3954
Practice Address - Country:US
Practice Address - Phone:773-947-7500
Practice Address - Fax:773-947-7896
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2021-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL209005929363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILPENDINGMedicare UPIN