Jennifer Nanettle Randolph LLC

Primary specialty

Private VehicleTaxonomy code 347C00000X

Legal business name

JENNIFER NANETTLE RANDOLPH LLC

Practice address

7715 S Cottage Grove
Ste, 1 DPT 198502
Chicago, IL 60619

Phone

(414) 304-4881

NPI assigned

Feb 2, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Nanettle Randolph, BM

Title

Manager

Phone

(414) 304-4881

Specialties & licenses 3

Addresses

Other names 1

• MIZZALLTHAT SPA Doing business as

Locations

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1306609292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7715 S COTTAGE GROVE",
            "address_2": "STE, 1 DPT 198502",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60619",
            "telephone_number": "414-304-4881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7715 S COTTAGE GROVE",
            "address_2": "STE, 1 DPT 198502",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60619",
            "telephone_number": "414-304-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER NANETTLE RANDOLPH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "RANDOLPH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "NANETTLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "414-304-4881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "BM"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIZZALLTHAT SPA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer L Kaleta DPM, LTD
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• Jennifer Langel Therapy PLLC
• Jennifer Lyn Thomas
• Jennifer Osborne DNP, Pmhnp-BC, Aprn PLLC
• Jennifer Palmer PSYD and Associates LLC
• Jennifer Phi,DDS,PC
• Jennifer Rothkopf, M.D., S.C.
• Jennifer Scherbauer DC ND PC

• Private Vehicle in Chicago, IL
• Providers in Chicago, IL by specialty
• Private Vehicle in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.