DR. RICHARD ELY BURGESS (NPI# 1649340530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649340530 |
| Entity Type | Individual |
| Full Name | DR. RICHARD ELY BURGESS |
| Credential | M.D., PH.D. |
| Practice Address |
1890 Silver Cross Blvd New Lenox IL 60451 |
| Mailing Address |
1890 Silver Cross Blvd New Lenox IL 60451-9524 |
| Practice Telephone | 8157234387 |
| Practice Fax Number | 8157234634 |
| Mailing Telephone | 8157234387 |
| Mailing Fax Number | 8157234634 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2018-11-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084V0102X |
Psychiatry & Neurology Specialization: Vascular Neurology |
036133825 | IL | Allopathic & Osteopathic Physicians |
| N | 2084V0102X |
Psychiatry & Neurology Specialization: Vascular Neurology |
MD035372 | DC | Allopathic & Osteopathic Physicians |
| N | 2084V0102X |
Psychiatry & Neurology Specialization: Vascular Neurology |
D63053 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE RAILROAD (INDIVIDUAL) | P01258410 | 01 |
| IL | 036133825 | 05 | |
| IL | MEDICARE RAILROAD (GROUP) | CA4748 | 01 |
| IL | MEDICARE (INDIVIDUAL PTAN) | F400099637 | 01 |
| IL | MEDICARE (GROUP PTAN) | 206147 | 01 |
| OH | 0319247 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871779454 | Richard Burgess | Pharmacist | 703 E Genesee St, Chittenango, NY 13037-1329 | 2008-01-14 |
| 1053463109 | Richard L Burgess | Dentist | 4721 Pecan Valley Dr, San Antonio, TX 78223-1630 | 2007-01-17 |
| 1396700357 | Richard K Burgess | Specialist/Technologist | 3577 Lala Rd, Lihue, HI 96766-9520 | 2006-04-20 |
| 1750815106 | Richard Burgess | Case Manager/Care Coordinator | 10201 Mission Gorge Rd, Santee, CA 92071-3027 | 2017-04-12 |
| 1003288754 | Richard Burgess | Physician Assistant | 391 Lee Blvd, Suite 400, Lehigh Acres, FL 33936-4973 | 2015-10-21 |
| 1154724011 | Richard Gilbert Burgess | Counselor | 3125 Myers St, Riverside, CA 92503-5527 | 2014-10-06 |
| 1164763645 | Richard Burgess | Occupational Therapist | 275 Commonwealth Dr, Greenville, SC 29615-4814 | 2013-03-08 |
| 1417109729 | Richard David Burgess | Specialist | 1248 32nd St, Sacramento, CA 95816-5210 | 2008-10-17 |
| 1336161702 | Richard Chipman Burgess | Pathology | 500 W Main St, Suite 201, Lewisville, TX 75057-3629 | 2006-07-24 |
| 1003852757 | Richard C Burgess | Psychiatry & Neurology | 9500 Euclid Ave, Suite S-51, Cleveland, OH 44195-0001 | 2006-06-21 |
| Street Address |
1890 SILVER CROSS BLVD |
| City | NEW LENOX |
| State | IL |
| Zip Code | 60451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841289691 | Mohammad Ashraf Toor | Internal Medicine | 1890 Silver Cross Blvd, Ste 320, New Lenox, IL 60451-9508 | 2005-10-14 |
| 1194373662 | Alyssa M Monsivais | Advanced Practice Midwife | 1890 Silver Cross Blvd, New Lenox, IL 60451-9524 | 2019-08-28 |
| 1346775574 | Andrew Hatfield | Nurse Practitioner | 1890 Silver Cross Blvd, Suite 570, New Lenox, IL 60451-9524 | 2017-04-25 |
| 1104367655 | Julia Grace Bania | Nurse Practitioner | 1890 Silver Cross Blvd, #210, New Lenox, IL 60451-9524 | 2017-03-16 |
| 1407390743 | Alison Barna | General Acute Care Hospital | 1890 Silver Cross Blvd, New Lenox, IL 60451-9524 | 2016-12-06 |
| 1215479621 | Lisa Abu-samra | Advanced Practice Midwife | 1890 Silver Cross Blvd, New Lenox, IL 60451-9524 | 2016-11-16 |
| 1841746567 | Becky Strilko | Registered Nurse | 1890 Silver Cross Blvd, New Lenox, IL 60451-9524 | 2016-09-01 |
| 1114370517 | Zafer Jawich Md Sc | Clinic/Center | 1890 Silver Cross Blvd, Ste 350, New Lenox, IL 60451-9524 | 2016-07-20 |
| 1154793412 | Forefront Dermatology, S.c. | Dermatology | 1890 Silver Cross Blvd, Suite 505, New Lenox, IL 60451 | 2015-10-27 |
| 1154704104 | Maria Wemple | Physician Assistant | 1890 Silver Cross Blvd, Suite 210, New Lenox, IL 60451-9524 | 2015-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871126227 | Forever Family Dental of New Lenox | Dentist | 202 Vancina Lane, New Lenox, IL 60451 | 2020-02-13 |
| 1699245662 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 115 East Maple St, New Lenox, IL 60451 | 2018-12-03 |
| 1093204778 | New Lenox Anesthesia LLC | Anesthesiology | 678 Cedar Crossing Dr, New Lenox, IL 60451 | 2018-05-08 |
| 1578068698 | My Medicar | Non-emergency Medical Transport (VAN) | 21625 S. Schoolhouse Rd, New Lenox, IL 60451 | 2018-03-29 |
| 1134646771 | Julianne M. Goudzwaard | Registered Nurse | 841 Buckboard Drive, New Lenox, IL 60451 | 2017-08-24 |
| 1063947422 | Silver Cross Ambulatory Surgery Center, LLC | Clinic/Center | 1003 Pawlak Parkway, New Lenox, IL 60451 | 2017-04-24 |
| 1386090041 | Lindsey Reimer | Speech-Language Pathologist | 3515 Golf Ave, New Lenox, IL 60451 | 2016-05-11 |
| 1295105484 | Alison Elaine Burchardt | Nurse Practitioner | 1890 Silver Cross Boulevard, Pavilion A, Suite 240, New Lenox, IL 60451 | 2015-09-30 |
| 1700278959 | Dental Professionals of Illinois, P.c | Dentist | 561 E Lincoln Hwy, New Lenox, IL 60451 | 2015-02-25 |
| 1912319146 | Teresea Bargewell | Counselor | 1049 E. Lincoln Hwy, Decision Point Counseling and Career Center, New Lenox, IL 60451 | 2014-05-22 |
| Find all providers in zip 60451 | ||||
| Taxonomy Code | 2084V0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Vascular Neurology |
| Vascular Neurology is a subspecialty in the evaluation, prevention, treatment and recovery from vascular diseases of the nervous system. This subspecialty includes the diagnosis and treatment of vascular events of arterial or venous origin from a large number of causes that affect the brain or spinal cord such as ischemic stroke, intracranial hemorrhage, spinal cord ischemia and spinal cord hemorrhage. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194105056 | Sebastian Urday | Psychiatry & Neurology | 259 E Erie St Ste 1900, Chicago, IL 60611-3246 | 2015-06-05 |
| 1023403565 | Gabriela Trifan | Psychiatry & Neurology | 1740 W Taylor St, Chicago, IL 60612-7232 | 2015-04-01 |
| 1619382355 | Chike Augustine Ilorah | Psychiatry & Neurology | 3635 Vista Avenue, Desloge Tower, 14th Floor, Suite 14032, Saint Louis, IL 63110 | 2014-06-20 |
| 1962781559 | Deepa Bhupali | Psychiatry & Neurology | 1801 W Taylor St, Chicago, IL 60612-2401 | 2011-08-12 |
| 1699003418 | Qingliang Tony Wang | Psychiatry & Neurology | 611 W Park St, Neurology, Urbana, IL 61801-2529 | 2009-12-07 |
| 1699937888 | Sarah Elizabeth Parker | Psychiatry & Neurology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2008-06-28 |
| 1437342870 | Naim Khoury | Psychiatry & Neurology | 421 N 9th St, Springfield, IL 62702-5317 | 2007-08-20 |
| 1669444683 | Edward M Manno | Psychiatry & Neurology | 675 N Saint Clair St, Chicago, IL 60611-5975 | 2006-02-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.