| Richard Ceragioli, MD | |
|
3700 W 203rd St Ste 201b, Olympia Fields, IL 60461-1182 | |
| (708) 679-2880 | |
| Not Available |
| Full Name | Richard Ceragioli |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 3700 W 203rd St Ste 201b, Olympia Fields, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346263704 | NPI | - | NPPES |
| 036084161 | Medicaid | IL | |
| IL5686027 | Other | IL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 036084161 (Illinois) | Primary |
| Entity Name | Specialty Physicians Of Illinois Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124075676 PECOS PAC ID: 4183529456 Enrollment ID: O20031201000602 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Ceragioli, MD 35318 Eagle Way, Chicago, IL 60678-1353 Ph: (317) 528-4800 | Richard Ceragioli, MD 3700 W 203rd St Ste 201b, Olympia Fields, IL 60461-1182 Ph: (708) 679-2880 |
Brie-ann Alexandra Muller, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 3800 W 203rd St Ste 204, Olympia Fields, IL 60461 Phone: 708-679-2670 Fax: 708-503-3260 | |
Neela Patel, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3700 W 203rd St, Suite 201, Olympia Fields, IL 60461 Phone: 708-679-2880 | |
Matt Stephen Hazelrigg, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 20201 Crawford Ave, Olympia Fields, IL 60461 Phone: 708-747-4000 | |
Ira Kumar, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3700 W 203rd St Ste 201, Olympia Fields, IL 60461 Phone: 708-679-2880 Fax: 708-503-3297 | |
Dalila K Irons Holland, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4001 Vollmer Rd, Olympia Fields, IL 60461 Phone: 708-481-8883 Fax: 708-481-2917 |