Active NPI
Richard Randolph
- Professional Counselor
- Chicago, IL
National Provider Identifier
1477172914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178012996
- Practice address
- 11740 S Western Ave
Chicago, IL 60643-4732 - Phone
- (312) 206-9131
- NPI assigned
- Apr 14, 2020
- Last updated
- Apr 14, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178012996 | IL | Primary |
Addresses
Primary practice location
11740 S Western Ave
Chicago, IL 60643-4732
Mailing address
3216 W 163Rd St
Markham, IL 60428-5410
Phone (312) 206-9131
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11740 S Western Ave
Chicago, IL 60643-4732
Phone (312) 241-3761
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Solutions Counseling and Consulting Group | Professional | Current | Accepting new patients |
Locations
11740 S Western Ave
Chicago, IL 60643
Phone (312) 206-9131
11740 S Western Ave
Ste 3
Chicago, IL 60643
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Professional Counselor
- Chicago, IL
- NPI 1083175764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586822400000",
"number": "1477172914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3216 W 163RD ST",
"city": "MARKHAM",
"state": "IL",
"postal_code": "604285410",
"telephone_number": "312-206-9131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11740 S WESTERN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606434732",
"telephone_number": "312-206-9131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDOLPH",
"first_name": "RICHARD",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-14",
"last_updated": "2020-04-14",
"certification_date": "2020-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178012996",
"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 Apr 14, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.