Doctor Name: | RICHARD L DAHL |
NPI Number: | 1285964700 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA |
License Number: | 085-003585 |
Business Practice Address: | 2615 Harrison St Bellwood, IL - 601042450 |
Business Phone Number: | 7084930199 |
Business Fax Number: | 7084939683 |
Mailing Address: | 2615 Harrison St, BELLWOOD |
State: | IL |
Postal Code: | 601042450 |
Phone Number: | 7084930199 |
Fax Number: | 7084939683 |
NPI Enumeration Date: | 01/06/2010 |
NPI Last Update Date: | 01/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 085-003585 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |