MEDICARE: RANDY MCCOOL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	31900	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	160034075	OTHER	KY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1088086	OTHER	KY	PASSPORT
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093711517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDY MCCOOL M.D.

Provider Business Mailing Address
First Line	:	1630 W CENTRAL RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2407
Country	:	US
Telephone Number	:	847-394-3553
Fax Number	:	847-394-3574

Provider Business Practice Location Address
First Line	:	1630 W CENTRAL RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2407
Country	:	US
Telephone Number	:	847-394-3553
Fax Number	:	847-394-3574

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	09/24/2012

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Directions to “ RANDY MCCOOL M.D.” Practice Location

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