Provider Demographics
NPI:1710092143
Name:ARRANDT, RICHARD ARTHUR (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ARTHUR
Last Name:ARRANDT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 N HERMITAGE AVE APT 320
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-9301
Mailing Address - Country:US
Mailing Address - Phone:312-919-8700
Mailing Address - Fax:
Practice Address - Street 1:2611 N HERMITAGE AVE APT 320
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-9301
Practice Address - Country:US
Practice Address - Phone:312-919-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007396111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1606342OtherBLUE CROSS BLUE SHIELD
ILU25198Medicare UPIN
IL382680Medicare ID - Type Unspecified