Randall, Samuel John

Randall, Samuel John is an individual health care provider with primary practice located at 1475 E Belvidere Rd Unit 385 , Grayslake IL 60030-2026. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Randall, Samuel John can be contacted via phone (312) 694-0484.

Contact Information

Primary practice address
1475 E Belvidere Rd Unit 385 Grayslake IL 60030-2026
Phone: (312) 694-0484
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X T2729 Texas
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1942704507
LBN Legal business name Randall, Samuel John
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2018
Last updated Jun 16th, 2023 - about last year

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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1942704507 NPPES
Michigan MEDICAID 1146320276

Popular Providers