Provider Demographics
NPI:1437983772
Name:RIBAR, RICHARD JR
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:RIBAR
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6555 WILLOW SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE HIGHLANDS
Mailing Address - State:IL
Mailing Address - Zip Code:60525-4591
Mailing Address - Country:US
Mailing Address - Phone:708-579-4900
Mailing Address - Fax:
Practice Address - Street 1:6555 WILLOW SPRINGS RD STE 6
Practice Address - Street 2:
Practice Address - City:LA GRANGE HIGHLANDS
Practice Address - State:IL
Practice Address - Zip Code:60525-4572
Practice Address - Country:US
Practice Address - Phone:708-579-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other