Anderson, Randa Mary
Anderson, Randa Mary is an sole proprietor health care provider with primary practice located at 5101 Washington St Ste 1102 , Gurnee IL 60031-2988. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Anderson, Randa Mary can be contacted via phone (847) 650-3952.Contact Information
Primary practice address
5101 Washington St Ste 1102
Gurnee IL 60031-2988
Phone: (847) 650-3952
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 071005722 | Illinois |
Profile Details
| NPI number | 1568563203 |
|---|---|
| LBN Legal business name | Anderson, Randa Mary |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 26th, 2006 |
| Last updated | Mar 20th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568563203 | NPPES |
| Illinois | Other | 7876053 | AETNA |
| Illinois | Other | 342742 | AETNA |
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