Kinsella, T Randall
Kinsella, T Randall is an individual health care provider with primary practice located at 917 Sherwood Dr , Lake Bluff IL 60044-2203. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Kinsella, T Randall can be contacted via phone (847) 295-1220.Contact Information
Primary practice address
917 Sherwood Dr
Lake Bluff IL 60044-2203
Phone: (847) 295-1220
Fax: (847) 295-1227
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 36069577 | Illinois |
Profile Details
| NPI number | 1245272418 |
|---|---|
| LBN Legal business name | Kinsella, T Randall |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Apr 14th, 2015 - about 9 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 | 1245272418 | NPPES |
| Illinois | MEDICAID | 36069577 |
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