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Individual

DR. KAREN M RANDALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
30 N MICHIGAN AVE, SUITE 1316, CHICAGO, IL 60602-3402
(312) 251-0755
Mailing address
30 N MICHIGAN AVE, SUITE 1316, CHICAGO, IL 60602-3402
(312) 251-0755

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0710004018
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01673426
BLUE CROSS OF IL PROVIDER
IL
Enumeration date
03/27/2007
Last updated
07/08/2007
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