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Individual
DR. RANDY LYLE CALISOFF
Active
Individual
DR. RANDY LYLE CALISOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
036-123018
IL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
036-123018
IL
208VP0014X
Interventional Pain Medicine Physician
036-123018
IL
Other
Enumeration date
10/02/2006
Last updated
04/22/2022
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