Individual
DR. MICHAEL RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2900 FOXFIELD RD STE 205, ST CHARLES, IL 60174-5799
(630) 315-1499
Mailing address
2900 FOXFIELD RD STE 205, ST CHARLES, IL 60174-5799
(630) 315-1499
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
070022033
IL
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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