Organization
RANDALL R RICKETTS OD LLC
Active
Other names
Eye Mechanix
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE ALEXAKOS (BUSINESS MANAGER)
(773) 857-1260
Entity
Organization
Contact information
Practice address
2338 N CLARK ST, CHICAGO, IL 60614-7043
(773) 857-1260
(773) 857-1624
Mailing address
1133 W PRATT BLVD APT 1, CHICAGO, IL 60626-6781
(773) 857-1260
(773) 857-1640
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003395633
NPI
IL
01
—
1083823611
NPI
IL
Enumeration date
06/29/2021
Last updated
04/15/2025
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