Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 10564 | SD |
N | 207Q00000X | Family Doctor | 1119 | SD |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 036.147372 | IL |
NPI | 1275587727 |
---|---|
Provider Name | Richard L Plummer |
First Address | Chicago, IL 60612-3800 |
Second Address | Chicago, IL 60612-3800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 21/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1119 | DAKOTACARE (01) | SD |
1256 | AVERA (01) | SD |
1565 | MIDLANDS CHOICE (01) | SD |
28190 | SANFORD HEALTH PLANS (01) | SD |
3971770 | (05) | IA |
4993464 | BLUE CROSS BLUE SHIELD (01) | SD |
5602648 | (05) | SD |
882068600 | (05) | MN |
AH1801016438 | PREFERRED ONE (01) | SD |
D25545 | (02) | SD |
P00397642 | RAILROAD MEDICARE (01) | SD |