MR. RICHARD RANDOLPH (NPI# 1477172914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477172914 |
| Entity Type | Individual |
| Full Name | MR. RICHARD RANDOLPH |
| Practice Address |
11740 S Western Ave Chicago IL 60643-4732 |
| Mailing Address |
3216 W 163rd St Markham IL 60428-5410 |
| Practice Telephone | 3122069131 |
| Mailing Telephone | 3122069131 |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
178012996 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982076246 | Richard Randolph | Physician Assistant | 1094 River Isle Dr, Memphis, TN 38103-8870 | 2015-10-27 |
| 1982681706 | Richard Nichols Randolph | Optometrist | 2240 Nash St N, Wilson, NC 27896-1729 | 2005-12-22 |
| 1497849665 | Richard Randolph | Dentist | 9850-c Emmett F. Lowry Expy, Suite C-103, Texas City, TX 77591 | 2006-10-03 |
| 1275632325 | Richard C Randolph | Family Medicine | 348 Crossgates Blvd, Suite 2200, Brandon, MS 39042-2616 | 2006-09-22 |
| 1649240953 | Richard Randolph | Pharmacist | 1277 Mcarthur St, Manchester, TN 37355-2423 | 2006-01-26 |
| 1992792188 | Richard Randolph IIi | Family Medicine | 12210 W 87th St, Lenexa, KS 66215-2812 | 2005-10-03 |
| Street Address |
11740 S WESTERN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60643-4732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487778536 | Community Counseling Centers of Chicago | Clinic/Center | 11740 S Western Ave, Chicago, IL 60643-4732 | 2007-03-16 |
| 1356955744 | Solutions Counseling and Consulting Group | Rehabilitation, Substance Use Disorder Unit | 11740 S Western Ave, Chicago, IL 60643-4732 | 2020-09-02 |
| 1114552486 | Jasmine Kayla Johnson | Counselor | 11740 S Western Ave, Chicago, IL 60643-4732 | 2020-03-07 |
| 1245528710 | Beacon Therapeutic School, Inc. | Clinic/Center | 11740 S Western Ave, Chicago, IL 60643-4732 | 2011-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154941698 | Breann Hampton | Behavior Technician | 1214 W 115th St, Chicago, IL 60643 | 2020-04-24 |
| 1366075566 | Sanctuary Counseling, LLC | Home Health | 12247 S Racine Ave, Calumet Park, IL 60643 | 2020-02-16 |
| 1467082883 | Juliana Frances Cunningham | Developmental Therapist | 10037 S Bell, Chicago, IL 60643 | 2020-01-24 |
| 1013578624 | Sct Counseling | Counselor | 11948 S Western Ave, Chicago, IL 60643 | 2019-06-25 |
| 1073087474 | For Eyes Optical Company of Pa | Optometrist | 9900 S Ridgleland Ave, Chicago Ridge, IL 60643 | 2019-01-18 |
| 1073096426 | Derek Peake | Physical Therapist | 9465 S. Western Road, Chicago, IL 60643 | 2018-09-12 |
| 1508356072 | Halo Medical Professionals Sc. | Chiropractor | 10650 S Western Ave, Chicago, IL 60643 | 2018-05-10 |
| 1811405699 | Kara Eileen Noland | Developmental Therapist | 9327 S Hamilton Ave, Chicago, IL 60643 | 2018-01-16 |
| 1588173546 | Kiah Nicole Bouie | Behavioral Analyst | 1461 W 113th Pl, Chicago, IL 60643 | 2017-09-21 |
| 1174042766 | Travis Wade Robertson | Physical Therapist | 10909-11 S Western Ave, Beverly, IL 60643 | 2017-09-14 |
| Find all providers in zip 60643 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477579 | Shantrell Patrice Sutton | Counselor | 5042 W Erie St, Chicago, IL 60644-1604 | 2020-11-05 |
| 1073114591 | Alternative Schools Network | Counselor | 1807 W Sunnyside Ave, Chicago, IL 60640-5898 | 2020-11-02 |
| 1992306518 | Gravity and Grace Psychotherapy, Pllc | Counselor | 1305 S Michigan Ave Apt 602, Chicago, IL 60605-3398 | 2020-11-02 |
| 1811597263 | April Wilburne | Counselor | 804 E 54th St Apt 3, Chicago, IL 60615-4972 | 2020-10-27 |
| 1043810393 | Pamela Kranyak | Counselor | 30 N Michigan Ave Ste 925, Chicago, IL 60602-3463 | 2020-10-27 |
| 1003413378 | Erika Aguirre | Counselor | 5040 S Keating Ave., Chicago, IL 60632-4919 | 2020-10-08 |
| 1497361661 | Michael V Biederman | Counselor | 4254 N Mozart St Apt 2s, Chicago, IL 60618-1784 | 2020-09-22 |
| 1013523984 | Antionette Fisher | Counselor | 5703 S Peoria St, Chicago, IL 60621-2262 | 2020-09-16 |
| 1114532561 | Nefesh Counseling, LLC | Counselor | 3320 W Foster Ave # 124, Chicago, IL 60625-4813 | 2020-09-12 |
| 1114531043 | Katherine E Evans | Counselor | 1528 W Jonquil Ter Unit 2c, Chicago, IL 60626-5932 | 2020-09-08 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.