Active NPI
Amber Tiffany Randolph, MD
- Ophthalmology Physician
- Chicago, IL
National Provider Identifier
1194200121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 036.178700
- Practice address
- 1009 S Wood St
Chicago, IL 60612-3747 - Phone
- (312) 996-7445
- NPI assigned
- Sep 25, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 036.178700 | IL | Primary |
Addresses
Primary practice location
1009 S Wood St
Chicago, IL 60612-3747
Mailing address
1009 S Wood St
Chicago, IL 60612-3747
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.178700 | IL | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779148800000",
"number": "1194200121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1009 S WOOD ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1009 S WOOD ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123747",
"telephone_number": "312-996-7445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDOLPH",
"first_name": "AMBER",
"middle_name": "TIFFANY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-25",
"last_updated": "2026-05-19",
"certification_date": "2026-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "IL",
"license": "036.178700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.