MEDICARE: F. J. RANDIN MD LTD

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	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0160415655	OTHER	IL	BLUE CROSS BLUE SHIELD OF ILLINOIS

General Provider Information

NPI Number	:	1235327172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	F. J. RANDIN MD LTD

Provider Business Mailing Address
First Line	:	250 E PEARSON ST APT 3202
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-5265
Country	:	US
Telephone Number	:	773-520-6555
Fax Number	:	773-586-6360

Provider Business Practice Location Address
First Line	:	7101 W ARCHER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60638-2203
Country	:	US
Telephone Number	:	773-520-6555
Fax Number	:	773-586-6360

Authorized Official
Title or Position	:	PROVIDER
Name	:	FRANCISCO J RANDIN
Credential	:	M.D.
Telephone Number	:	773-520-6555

Provider Enumeration Date	:	10/04/2007
Last Update Date	:	08/12/2008

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