Individual provider · Type 1 NPI
Risha Raven Fennell, MD
Addiction Medicine (Family Medicine) Physician · Springfield, IL
NPI number
1487622379
Active
Practice location
2501 Chatham Rd Ste 4713
Springfield, IL 62704-4188
Mailing address
900 Beech St
Normal, IL 61761-1803
Other practice locations
- 1096 1350th St, Lincoln, IL 62656-5094 · (217) 735-5581
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine Physician | 207Q00000X | 036100518 (IL) |
| Addiction Medicine (Family Medicine) Physician Primary | 207QA0401X | 036100518 (IL) |
Addiction Medicine (Family Medicine) Physician: A family medicine physician who specializes in the diagnosis and treatment of addictions.
About NPI 1487622379
Risha Raven Fennell, MD's National Provider Identifier is 1487622379, issued on Mar 8, 2006. The primary taxonomy on file is Addiction Medicine (Family Medicine) Physician (207QA0401X), and the practice location is in Springfield, IL. The record was last updated on Jun 7, 2024.