Basic Information
| Provider Information | |||||||||
| NPI: | 1639801533 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TORRES | ||||||||
| FirstName: | RICHIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | APN-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 746721 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303746721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1273397303 | ||||||||
| FaxNumber: | 7738668015 | ||||||||
| Practice Location | |||||||||
| Address1: | 4848 W IRVING PARK RD | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606412718 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7737246200 | ||||||||
| FaxNumber: | 7738668015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2022 | ||||||||
| LastUpdateDate: | 08/29/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WG0000X | 041384019 | IL | N | Nursing Service Providers | Registered Nurse | General Practice | 363LA2200X | 209.025417 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.