| Doctor Name: | ANDREW RICHARDSON |
| NPI Number: | 1144639527 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | APN |
| License Number: | 209.011662 |
| Business Practice Address: | 180 Harvester Dr Suite 110 Burr Ridge, IL - 605277594 |
| Business Phone Number: | 7737021150 |
| Business Fax Number: | |
| Mailing Address: | 5841 S Maryland Ave, CHICAGO |
| State: | IL |
| Postal Code: | 606371447 |
| Phone Number: | 7738343561 |
| Fax Number: | |
| NPI Enumeration Date: | 08/11/2014 |
| NPI Last Update Date: | 10/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | 209.011662 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |