Provider Demographics
NPI:1578736252
Name:RESCHKE, RICHARD A (DN)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:RESCHKE
Suffix:
Gender:M
Credentials:DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4133 N. SPRINGFIELD AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618
Mailing Address - Country:US
Mailing Address - Phone:312-375-2134
Mailing Address - Fax:312-886-8863
Practice Address - Street 1:141 W. JACKSON BOULEVARD
Practice Address - Street 2:SUITE 2170
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604
Practice Address - Country:US
Practice Address - Phone:312-886-8864
Practice Address - Fax:312-886-8863
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath