Randall Medical LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

RANDALL MEDICAL LLC

Practice address

923 S Randall Rd
Saint Charles, IL 60174-1556

Phone

(630) 601-3361

Fax

(630) 485-6984

NPI assigned

Jan 27, 2021

Organization subpart

No

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

Authorized official

Name

Chanele Smith

Title

Manager

Phone

(239) 260-0530

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1730770348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 S RANDALL RD",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601741556",
            "telephone_number": "630-601-3361",
            "fax_number": "630-485-6984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 S RANDALL RD",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601741556",
            "telephone_number": "630-601-3361",
            "fax_number": "630-485-6984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CHANELE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "239-260-0530"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Jeremiah Rafferty, MSW, LSW
• Nuvano Preethi Rajan Jayakumar, PMHNP
• Yesenia Ramirez
• Kaushal Ramkumar, RN, BSN
• Rommel Ram Ramos, PTA
• Michael Randall, DPT
• Kiran Rauf
• Amita Raval, PHARMD
• Shawn Thomas Ray
• Rosa Raya, INTERPRETER

• General Practice Physician in Saint Charles, IL
• Providers in Saint Charles, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.