Individual
DR. KIM RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
7941 OGDEN AVE, LYONS, IL 60534-1580
(708) 788-2626
Mailing address
7941 OGDEN AVE, LYONS, IL 60534-1580
(708) 788-2626
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001627000
BLUECROSS BLUE SHIELD
IL
Enumeration date
02/01/2007
Last updated
07/08/2007
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