Randall, Jerome R
Randall, Jerome R is an sole proprietor health care provider with primary practice located at 19900 Governors Dr #12, Olympia Fields IL 60461-1057. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Randall, Jerome R can be contacted via phone (708) 898-2380.Contact Information
Primary practice address
19900 Governors Dr #12
Olympia Fields IL 60461-1057
Phone: (708) 898-2380
Fax: (708) 898-2326
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 016-005113 | Illinois |
Profile Details
| NPI number | 1376689257 |
|---|---|
| LBN Legal business name | Randall, Jerome R |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 29th, 2007 |
| Last updated | Aug 17th, 2022 - about 2 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 | 1376689257 | NPPES |
| Illinois | MEDICAID | 016005113 |
Popular Providers
-
Balazic, Rhiannon M
3302 Vollmer Rd , Olympia Fields IL 60461-1179 -
Shearer, Paul
1970 Roanoke Blvd , Salem VA 24153-6404 -
Mazur, Mark J.
420 N James Rd , Columbus OH 43219-1834 -
Narcisi, Frank
20201 Crawford Ave Suite 1400, Olympia Fields IL 60461-1010 -
Morgan, Jack
500 N Garfield Ave Ste 108, Monterey Park CA 91754-1242 -
Farrer, Ann
2148 Ami Ln , Lexington KY 40516-9602 -
Nadalin, Richard
453 Waterbury Ct Ste 200, Gahanna OH 43230-5309 -
Black, Gregory A
4913 Harroun Rd , Sylvania OH 43560-2197