Provider Demographics
NPI:1548277817
Name:ONDRAS, RICHARD JOSEPH (DC,DN)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOSEPH
Last Name:ONDRAS
Suffix:
Gender:M
Credentials:DC,DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11301 DISTINCTIVE DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-9460
Mailing Address - Country:US
Mailing Address - Phone:708-478-3100
Mailing Address - Fax:708-478-4382
Practice Address - Street 1:11301 DISTINCTIVE DR
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-9460
Practice Address - Country:US
Practice Address - Phone:708-478-3100
Practice Address - Fax:708-478-4382
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00256386OtherRAILROAD MEDICARE
ILU92122Medicare UPIN
IL212252Medicare ID - Type Unspecified