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General NPI Number Information
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NPI Number | 1538287297
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Entity Type | Organization
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Legal Business Name | RANDALL F. SUMMERS, D.D.S.,LTD
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 391 QUADRANGLE DR SUITE S-5
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City | BOLINGBROOK
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State | IL
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Zip | 60440-3442
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Country | US
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Telephone | 630-759-4400
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Fax | 630-759-9528
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Provider Business Mailing Address
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Address Line | 391 QUADRANGLE DR SUITE S-5
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City | BOLINGBROOK
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State | IL
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Zip | 60440-3442
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Country | US
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Telephone | 630-759-4400
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Fax | 630-759-9528
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RANDALL FRANK SUMMERS
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Credential | D.D.S.
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Telephone | 630-759-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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