1275587727 NPI number — RICHARD L PLUMMER MD

Table of content: RICHARD L PLUMMER MD (NPI 1275587727)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275587727 NPI number — RICHARD L PLUMMER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PLUMMER
Provider First Name:
RICHARD
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275587727
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
RUSH UNIVERSITY MEDICAL CENTER
Provider Second Line Business Mailing Address:
1653 W CONGRESS PARKWAY
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60612-3800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-215-2185
Provider Business Mailing Address Fax Number:
605-653-3226

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
RUSH UNIVERSITY MEDICAL CENTER
Provider Second Line Business Practice Location Address:
1653 W CONGRESS PARKWAY
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60612-3800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-215-2185
Provider Business Practice Location Address Fax Number:
605-653-3226
Provider Enumeration Date:
05/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  10564 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 1119 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QA0401X , with the licence number: 036.147372 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3971770 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 882068600 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1256 . This is a "AVERA" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 1565 . This is a "MIDLANDS CHOICE" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 5602648 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1119 . This is a "DAKOTACARE" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: AH1801016438 . This is a "PREFERRED ONE" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 28190 . This is a "SANFORD HEALTH PLANS" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 4993464 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: P00397642 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".




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