Individual
DR. RANDOLPH Y. CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(717) 531-6597
Mailing address
425 JOLIET ST., SUITE 400, DYER, IN 46311
(219) 865-3819
(219) 865-5401
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
036088768
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD483068
PA
208VP0000X
Pain Medicine Physician
036-088768
IL
208VP0014X
Interventional Pain Medicine Physician
01066493A
IN
208VP0014X
Interventional Pain Medicine Physician
036088768
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036088768
—
IL
01
—
11528006
CAQH
—
05
—
201003790
—
IN
Enumeration date
06/23/2006
Last updated
11/13/2024
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