Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 036114011 | IL |
Y | 111NI0900X | Internist | 036114011 | IL |
N | 207RA0401X | Internist - Addiction Medicine | 2015472 | IL |
NPI | 1093706319 |
---|---|
Provider Name | Dr. Richa Varma |
First Address | Chicago, IL 60674-8055 |
Second Address | Itasca, IL 60143-3128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 28/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036114011 | (05) | IL |
IL5839 | (02) | IL |