Randy L. Kettering PHD, PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

060004613 Issued in IL

Legal business name

RANDY L. KETTERING PHD, PC

Practice address

807 Davis St Unit 605
Evanston, IL 60201-4820

Phone

(847) 934-8475

NPI assigned

May 3, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Randy Lee Kettering, PH.D.

Title

President

Phone

(847) 934-8475

Specialties & licenses 1

Addresses

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1194937359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 DAVIS ST UNIT 605",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014820",
            "telephone_number": "847-934-8475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 DAVIS ST UNIT 605",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014820",
            "telephone_number": "847-934-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDY L. KETTERING PHD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "KETTERING",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-934-8475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "060004613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rlkphd@comcast.net",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "807 Davis St Unit 605",
            "city": "Evanston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "602014820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ramjac Corp Inc
• Jordan Lee Ramsdell, LCSW
• Joanne J Ramseyer, LCPC
• Ushan Ashley Ranasinghe, MD
• Kristen G. Randall, O.D.
• Randy Walker, M.S.
• Tanya Ranginwala, DMD
• Pitud Allan Rangsithienchai, M.D.
• David Ransburg Jr.
• Esther L Ransom, LCPC

• Clinical Psychologist in Evanston, IL
• Providers in Evanston, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.