Individual
RANDOLPH RAJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
111 E WASHINGTON ST, BENSENVILLE, IL 60106-2674
(630) 521-8252
Mailing address
111 E WASHINGTON ST, BENSENVILLE, IL 60106-2674
(630) 521-8252
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004275
IL
Other
Enumeration date
07/15/2008
Last updated
07/15/2008
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