DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. RICHARD DOUGLAS SOUTHGATE, M.D.

Active

DR. RICHARD DOUGLAS SOUTHGATE, M.D. is a Sports Medicine (Orthopaedic) healthcare provider located in LAKE FOREST, Illinois. NPI 1720303308 is currently active in the NPPES registry. Verify at CMS.

Sports Medicine (Orthopaedic) · LAKE FOREST, IL

Registration Details

NPI Number
1720303308
Provider Type
Individual
Gender
Male
NPI Issued
Apr 7, 2010 (16.401627162206 yrs)
Last Updated
Feb 2, 2023
Licenses
142231 (CA)
036162961 (IL)

Practice Information

Address
1000 N WESTMORELAND RD # LEVEL3
LAKE FOREST, IL, 600451658
Browse IL providers · Browse ZIP 60045
Phone
8475358500
Fax
8475358499
Primary Specialty
Sports Medicine (Orthopaedic)
207XS0114X
Additional Specialty
Sports Medicine (Orthopaedic)
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.