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Samuel John Randall
Student in an Organized Health Care Education/Training Program in Grayslake, Illinois
NPI 1942704507

Samuel John Randall is a Student in an Organized Health Care Education/Training Program based in Houston, IL. Samuel John Randall practices in Grayslake, IL. The NPI Number for Samuel John Randall is 1942704507 and holds a License No. T2729 (Illinois).

The current practice location address for Samuel John Randall is 1475 E Belvidere Rd Unit 385, Grayslake, IL and can be reached out via phone at 312-694-0484.

Location: 1475 E Belvidere Rd Unit 385, Grayslake, IL, 77030-1608
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1942704507
Provider Name
Samuel John Randall
Credential
Provider Entity Type
Individual
Gender
Male
Address
1475 E Belvidere Rd Unit 385, Grayslake, IL, 77030-1608
Phone Number
312-694-0484
Fax Number
Provider Enumeration Date
03/20/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1146320276 05 MI
institution
Provider Business Practice Location Address Details
Address
1475 E Belvidere Rd Unit 385
City
Grayslake
State
Illinois
Zip
60030-2026
Phone Number
312-694-0484
Fax Number
person
Provider Business Mailing Address Details
Address
1475 E Belvidere Rd Unit 385
City
Grayslake
State
Illinois
Zip
60030-2026
Phone Number
312-694-0484
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
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Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
T2729 (Texas)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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