Provider Demographics
NPI:1689631681
Name:HARTMANN, RICHARD A (PT, MS, ATC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:A
Last Name:HARTMANN
Suffix:
Gender:M
Credentials:PT, MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 CORPORATE WOODS PKWY
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-3111
Mailing Address - Country:US
Mailing Address - Phone:847-634-0400
Mailing Address - Fax:847-634-0770
Practice Address - Street 1:555 CORPORATE WOODS PKWY
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-3111
Practice Address - Country:US
Practice Address - Phone:847-634-0400
Practice Address - Fax:847-634-0770
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096-0006272255A2300X
IL070-0108112251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00403794Medicare PIN
ILF400202790Medicare PIN