Individual
DR. RANDY LYLE CALISOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
355 E ERIE ST FL 14, CHICAGO, IL 60611-3167
(312) 238-7800
(312) 238-7801
Mailing address
355 E ERIE ST FL 14, CHICAGO, IL 60611-3167
(312) 238-7800
(312) 238-7801
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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036123018-1
—
IL
Enumeration date
10/02/2006
Last updated
04/22/2022
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