DR. JACOB RUSSELL RANDICH


Address: 5666 E State St, Rockford, IL 61108-2425
Phone: 8152262000

DR. JACOB RUSSELL RANDICH (NPI# 1922668755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922668755
Entity Type Individual
Full Name DR. JACOB RUSSELL RANDICH
Credential DPM
Practice Address 5666 E State St
Rockford
IL 61108-2425
Mailing Address 646 Vine St
Hampshire
IL 60140-5620
Practice Telephone 8152262000
Mailing Telephone 6303378353
Enumeration Date 2019-06-14
Last Update Date 2019-06-14
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 213E00000X Podiatrist 135.001050 IL Podiatric Medicine & Surgery Service Providers

Office Location

Street Address 5666 E STATE ST
City ROCKFORD
State IL
Zip Code 61108-2425

Providers in the same location

NPI Name Taxonomy Address Enumeration
1508849209 Richard Emery Freeman Neurological Surgery 5666 E State St, Rockford, IL 61108-2425 2005-11-28
1881293348 Salman Nafees Nurse Anesthetist, Certified Registered 5666 E State St, Rockford, IL 61108-2425 2020-10-25
1346856424 Keely K Zunker Nurse Practitioner 5666 E State St, Rockford, IL 61108-2472 2020-09-23
1962026476 Angie Youssef Hernandez Student in an Organized Health Care Education/Training Program 5666 E State St, Rockford, IL 61108-2425 2020-06-01
1568085710 Kelsey Surowiec Student in an Organized Health Care Education/Training Program 5666 E State St, Rockford, IL 61108-2425 2020-05-22
1801415864 Kyle R Clark Physician Assistant 5666 E State St, Rockford, IL 61108-2425 2020-04-10
1508495144 Sadie Jae Pierce-mulligan 5666 E State St, Rockford, IL 61108-2425 2020-04-06
1376170183 Nicole Ann O'neill Dietitian, Registered 5666 E State St, Rockford, IL 61108-2425 2020-03-24
1447884804 Marissa Ann Giannangeli Occupational Therapist 5666 E State St, Rockford, IL 61108-2425 2020-02-25
1023659711 Erin R. Moody Physician Assistant 5666 E State St, Rockford, IL 61108-2425 2019-10-03
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952862617 Isr Enterprises, Inc. Homemaker 129 Phelps Ave, Bldg 10, Ste 1008, Rockford, IL 61108 2019-03-26
1003306465 Adrienne Nicole Black Behavior Technician 519 Woodland Dr, Woodland Dr, Rockford, IL 61108 2018-05-11
1184085201 Integrative Healing Center, LLC Clinic/Center 6019 Fincham Drive, Rockford, IL 61108 2016-03-17
1730547936 Perryville Dentist PC Dentist 845 S Perryville Rd, Unit 119, Rockford, IL 61108 2016-02-02
1023489853 Nicole Ping Ticknor Counselor 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 2015-10-20
1275940348 Northwest Home Care, Inc. Home Health 1437 S. Bell School Road, Suite 7, Rockford, IL 61108 2014-07-21
1487072922 Alecia Greenlee Psychiatry & Neurology Rosecrance Community Mental Health, 3815 Harrison Avenue, Rockford, IL 61108 2014-04-02
1871925446 Maria Laura Gustafson Interpreter 3208 Wesleyan Ave., Rockford, IL 61108 2013-08-06
1346582822 Joseph Peevey Pathology 5666 E State Street, Department of Pathology, Rockford, IL 61108 2013-03-21
1134466923 James Henry Peck Hearing Instrument Specialist 2424 Charles St, Rockford, IL 61108 2013-01-14
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Taxonomy Information

Taxonomy Code 213E00000X
Grouping Podiatric Medicine & Surgery Service Providers
Classification Podiatrist

Taxonomy Definition

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1265895239 Richard Bell Podiatrist 6055 Boxwood Dr, Rockford, IL 61114-6559 2016-03-29
1801025473 Nathan Norem Podiatrist 2300 N Rockten Ave, Rockford, IL 61103-3619 2009-07-05
1508967621 Matthew S. Keene Podiatrist 4777 East State Street, Suite 8, Rockford, IL 61108 2006-09-25
1497854053 Philip W Seeber Podiatrist 3851 N Mulford, Rockford, IL 61114 2006-09-21
1215042965 Paul A Galluzzo Podiatrist 6999 Redansa Drive, Rockford, IL 61108-1201 2006-08-21
1497731293 Thomas A Runne Podiatrist 1437 S Bell School Rd Ste 2, Rockford, IL 61108-1405 2005-12-22
1316507890 Ashley Ann Smith Podiatrist 324 Roxbury Rd, Rockford, IL 61107-5090 2019-06-18
1184144727 Donald C Bisby Podiatrist 324 Roxbury Rd, Rockford, IL 61107-5090 2017-06-25
1700239332 Tiphani James Podiatrist 5666 E State St, Rockford, IL 61108-2425 2016-07-19
1235326455 Thomas A Runne Dpm Ltd Podiatrist 1437 S Bell School Rd Ste 2, Rockford, IL 61108-1405 2007-10-02
Find all providers in ROCKFORD

Competitor

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City ROCKFORD
Zip Code 61108

Improve Information

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Dataset Information

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.

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