Eden, Richard T

Eden, Richard T is an individual health care provider with primary practice located at 900 N 1St St , Springfield IL 62702-3749. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Gynecology. Allopathic & Osteopathic Physicians / Gynecology is his primary health care specialty. Eden, Richard T can be contacted via phone (217) 528-7541.

Contact Information

Primary practice address
900 N 1St St Springfield IL 62702-3749
Phone: (217) 528-7541
Fax: (217) 525-0121
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 036119111 Illinois
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 036119111 Illinois

Profile Details

NPI number 1477589992
LBN Legal business name Eden, Richard T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2006
Last updated Mar 26th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477589992 NPPES
Illinois MEDICAID 036119111

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