DR. Risha Raven Fennell, MD
NPI #1487622379 in Springfield, Illinois
Provider Information
- NPI Number
- 1487622379
- Entity Type
- Individual
- Name
- DR. Risha Raven Fennell, MD
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Family Medicine - Addiction Medicine
- Credential
- MD
- Enumeration Date
- Mar 8, 2006
- Last Updated
- Jun 7, 2024
Practice Location
- Address
- 2501 CHATHAM RD STE 4713
- City
- Springfield
- State
- Illinois
- ZIP Code
- 62704-4188
- Phone
- (779) 429-2227
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
| Family Medicine - Addiction Medicine — Addiction Medicine |
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