Active NPI
Randall Dale Hayes, RSA
- Surgical Technologist
- Glendale Heights, IL
National Provider Identifier
1881775880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- 238000042
- Practice address
- 1123 Cedar St
Apt. 1-a
Glendale Heights, IL 60139 - Phone
- (630) 520-8697
- Fax
- (630) 909-0991
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | 238000042 | IL | Primary |
Addresses
Primary practice location
1123 Cedar St
Apt. 1-a
Glendale Heights, IL 60139
Mailing address
PO Box 5102
Glendale Heights, IL 60139-5102
Phone (630) 303-6915
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
| License | State | Type | Specialty |
|---|---|---|---|
| 238000042 | IL | MD | Surgical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370908800000",
"number": "1881775880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5102",
"city": "GLENDALE HEIGHTS",
"state": "IL",
"postal_code": "601395102",
"telephone_number": "630-303-6915",
"fax_number": "630-909-0991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1123 CEDAR ST",
"address_2": "APT. 1-A",
"city": "GLENDALE HEIGHTS",
"state": "IL",
"postal_code": "60139",
"telephone_number": "630-520-8697",
"fax_number": "630-909-0991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYES",
"first_name": "RANDALL",
"middle_name": "DALE",
"name_prefix": "Mr.",
"credential": "RSA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2013-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "IL",
"license": "238000042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.