Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. RISHA RAVEN FENNELL, MD
Active Sole ProprietorDR. RISHA RAVEN FENNELL, MD is a Addiction Medicine (Family Practice) healthcare provider located in SPRINGFIELD, Illinois. NPI 1487622379 is currently active in the NPPES registry. Verify at CMS.
Addiction Medicine (Family Practice) · SPRINGFIELD, IL
Registration Details
- NPI Number
- 1487622379
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 8, 2006 (20.453331957925 yrs)
- Last Updated
- Jun 7, 2024
- Licenses
-
036100518 (IL)036100518 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2501 CHATHAM RD STE 4713SPRINGFIELD, IL, 627044188Browse IL providers · Browse ZIP 62704
- Phone
- 7794292227
- Primary Specialty
-
Addiction Medicine (Family Practice)
207QA0401X
- Additional Specialty
- Addiction Medicine (Family Practice)
Other Addiction Medicine (Family Practice) Providers in SPRINGFIELD, IL
| Name | Credential | NPI |
|---|---|---|
| BRIAN A BEARD | MD | 1861458846 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.