Active NPI
Dylan Randall, DPT
- Physical Therapist
- Schaumburg, IL
National Provider Identifier
1780035873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.022372
- Practice address
- 2562 W Schaumburg Rd
Schaumburg, IL 60194-3897 - Phone
- (847) 519-3485
- Fax
- (847) 519-3614
- NPI assigned
- Jun 29, 2016
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.022372 | IL | Primary |
Addresses
Primary practice location
2562 W Schaumburg Rd
Schaumburg, IL 60194-3897
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.022372 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470960000000",
"number": "1780035873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223",
"fax_number": "630-759-9510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2562 W SCHAUMBURG RD",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601943897",
"telephone_number": "847-519-3485",
"fax_number": "847-519-3614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "DYLAN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-29",
"last_updated": "2016-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.022372",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Schaumburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.