NPIMap

Individual provider Active NPI

David Paul Randall, DO

  • Neurology Physician
  • Park Ridge, IL
National Provider Identifier
1568521441
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036094427 Issued in IL
Practice address
1875 Dempster St Ste 660
Park Ridge, IL 60068-1168
Phone
(847) 723-4088
NPI assigned
Dec 7, 2006
Last updated
Jun 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036094427 IL Primary

Addresses

Primary practice location

1875 Dempster St Ste 660
Park Ridge, IL 60068-1168

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

2100 Pfingsten Rd
Suite 3000
Glenview, IL 60026-1301
Phone (847) 657-5875

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address drandall206871@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050909000648 IL Practitioner - Neurology 0941232953 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Chicago College of Osteopathy, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1412 Waukegan Rd
Glenview, IL 60025-2121
Phone (847) 901-9880

1775 Dempster St
Park Ridge, IL 60068-1143

1875 Dempster St
Park Ridge, IL 60068-1192

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

2600 Compass Rd
Glenview, IL 60026-8001

825 S Milwaukee Ave
Libertyville, IL 60048-3218
Phone (847) 362-1393

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036094427ILMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Feb 1, 2000 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 6, 2018 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Jul 6, 2018 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2100 Pfingsten Rd
Glenview, IL 60026
Phone (847) 657-5800

2100 Pfingsten Rd
Ste 3000
Glenview, IL 60026
Phone (847) 503-4342

1875 W Dempster St
Ste 660
Park Ridge, IL 60068
Phone (847) 698-1210

Interoperability endpoints

  • Direct secure messaging: drandall206871@direct.myadvocateaurora.org

Organizations & group practices 6

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1568521441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER ST STE 660",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681168",
            "telephone_number": "847-723-4088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Pfingsten Rd",
            "address_2": "Suite 3000",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "600261301",
            "country_code": "US",
            "telephone_number": "847-657-5875",
            "fax_number": "847-570-5708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "DAVID",
        "middle_name": "PAUL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-07",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036094427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drandall206871@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1875 Dempster St Ste 660",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681168",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1875 Dempster St Ste 660",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.