Randall Warren Summerville in Lombard - Clinical
Randall Warren Summerville - NPI 1821180803
Randall Warren Summerville is a Clinical in Lombard, Illinois. Randall Warren Summerville practices all healthcare services and medical treatments related to Clinical. The NPI Number for Randall Warren Summerville is 1821180803. The last update date is 2022-12-05.
Randall Warren Summerville's current location address is 477 E Butterfield Rd Ste 102, Lombard, Illinois. You can contact this provider via phone number 6304248900 and fax number 6304249017. The mailing address for Randall Warren Summerville is 477 E Butterfield Rd Ste 102, Lombard, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Randall Warren Summerville |
|---|---|
| Address | 477 E Butterfield Rd Ste 102, Lombard, Illinois |
| Phone Number | 6304248900 |
| Fax Number | 6304249017 |
| Sole Proprietor | Y |
| Credentials | PSYD |
NPI Number Detail
| NPI Number | 1821180803 |
|---|---|
| Provider Enumeration Date | 2006-09-28 |
| Last Updated Date | 2022-12-05 |
Provider Mailing Address Detail
| Address | 477 E Butterfield Rd Ste 102 |
|---|---|
| City | Lombard |
| State | Illinois (IL) |
| Post Code | 601484880 |
| Phone Number | 6304248900 |
| Fax Number | 6304249017 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 071-006658 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2233000 | IL | BCBS OF IL GROUP PROVIDER | |
| 071-0006658 | IL | PROFESSIONAL LICENSE |
Post Comment/ Review Below
What is the Randall Warren Summerville's 1821180803?
The Randall Warren Summerville's NPI (National Provider Identifier) Number is 1821180803. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Randall Warren Summerville is physically located?
The Randall Warren Summerville is situated at the following address: 477 E Butterfield Rd Ste 102, Lombard, IL 601484880.
What is Randall Warren Summerville's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Randall Warren Summerville is Clinical, and the corresponding taxonomy classification code for this specialized field is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services issue the 1821180803 to Randall Warren Summerville?
The Randall Warren Summerville received its 1821180803 assignment from the Centers for Medicare & Medicaid Services on 2006-09-28.
When was the information regarding Randall Warren Summerville, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Randall Warren Summerville, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2022-12-05.