Individual provider Active NPI

Angela Randle

  • Driver
  • Romeoville, IL
National Provider Identifier
1841586518
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
172A0000X Issued in IL
Practice address
415 Walden CT
Romeoville, IL 60446-1078
Phone
(773) 954-5440
NPI assigned
Jun 21, 2011
Last updated
Jun 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X 172A0000X IL Primary

Addresses

Primary practice location

415 Walden CT
Romeoville, IL 60446-1078

Mailing address

415 Walden CT
Romeoville, IL 60446-1078
Phone (773) 954-5440

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
172A0000XILMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1841586518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 WALDEN CT",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604461078",
            "telephone_number": "773-954-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 WALDEN CT",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604461078",
            "telephone_number": "773-954-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDLE",
        "first_name": "ANGELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-21",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "IL",
            "license": "172A0000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Romeoville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; 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.