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NPI Code Detail

MEDICARE: RANJIV RANDALL S RANDHAWA MD

MEDICARE: RANJIV RANDALL S RANDHAWA MD
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
1207R00000XInternal Medicine PhysicianMD00045355WA
2207R00000XInternal Medicine Physician036-133007IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295799906
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANJIV RANDALL S RANDHAWA MD
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number : 847-390-5900
Fax Number :
Provider Business Practice Location Address
First Line : 2320 E 93RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60617-3909
Country : US
Telephone Number : 773-967-5805
Fax Number : 773-967-5808
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2006
Last Update Date : 11/18/2022

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