MEDICARE: RANDI ELYN SMULSON 019027653

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	122300000X	Dentist	019027653	IL
2	1223G0001X	General Practice Dentistry	019027653	IL

General Provider Information

NPI Number	:	1780834580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDI ELYN SMULSON 019027653

Provider Business Mailing Address
First Line	:	1725 W NORTH AVE
Second Line	:	SUITE 102
City	:	CHICAGO
State	:	IL
Zip	:	60622-2188
Country	:	US
Telephone Number	:	773-227-1048
Fax Number	:	773-227-3218

Provider Business Practice Location Address
First Line	:	1725 W NORTH AVE
Second Line	:	SUITE 102
City	:	CHICAGO
State	:	IL
Zip	:	60622-2188
Country	:	US
Telephone Number	:	773-227-1048
Fax Number	:	773-227-3218

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

Provider Enumeration Date	:	09/29/2008
Last Update Date	:	02/02/2009

Similar Medicare Providers

1881813970 — DR. PRISCILLA YEUNG
Practice Location Address:

1725 W NORTH AVE , SUITE 102
CHICAGO, IL
60622-2188

Practice Phone: 773-227-1048
Practice Fax: 773-227-3218

1710212360 — DR. MARY ELIZABETH HAUPERS DDS
Practice Location Address:

1725 W NORTH AVE
CHICAGO, IL
60622-2188

Practice Phone: 773-227-1048
Practice Fax:

1730186248 — DEANA HERRMAN & PATRICE LASSA, PC
Practice Location Address:

819 S WABASH AVE , STE 208
CHICAGO, IL
60605-2188

Practice Phone: 312-386-9028
Practice Fax:

1700167004 — CHRISTOPHER WANG
Practice Location Address:

6328 N BELL AVE
CHICAGO, IL
60659-2188

Practice Phone: 773-771-4181
Practice Fax:

1790576544 — UNIVERSALL HEALING
Practice Location Address:

1433 W SUMMERDALE AVE APT 2A
CHICAGO, IL
60640-2188

Practice Phone: 312-848-6582
Practice Fax:

1659223840 — HOFFMAN OF BUCKTOWN PLLC
Practice Location Address:

1934 W NORTH AVE
CHICAGO, IL
60622-1318

Practice Phone: 312-219-5448
Practice Fax:

Directions to “ RANDI ELYN SMULSON 019027653” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.