Provider Demographics
NPI:1972632438
Name:ALEXANDER, RICHARD B (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:B
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 HEDLEY RD
Mailing Address - Street 2:PO BOX 13484
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62711-6248
Mailing Address - Country:US
Mailing Address - Phone:217-726-7300
Mailing Address - Fax:217-726-5989
Practice Address - Street 1:3225 HEDLEY RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62711-6248
Practice Address - Country:US
Practice Address - Phone:217-726-7300
Practice Address - Fax:217-726-5989
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL682221Medicare PIN
ILC42695Medicare UPIN