Provider Demographics
NPI:1881957405
Name:RIOS, RICARDO R (MD)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:R
Last Name:RIOS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 W ADDISON ST STE 305
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-4468
Mailing Address - Country:US
Mailing Address - Phone:773-725-0760
Mailing Address - Fax:773-725-9554
Practice Address - Street 1:5600 W ADDISON ST STE 305
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4468
Practice Address - Country:US
Practice Address - Phone:773-725-0760
Practice Address - Fax:773-725-9554
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13124-320208800000X
IL036-144221208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty