| Diane Randall Clinical Services Pc | |
|
109 Dundee Ave Barrington IL 60010-4201 | |
| (847) 446-7636 | |
| Not Available |
| Full Name | Diane Randall Clinical Services Pc |
|---|---|
| Speciality | Psychologist |
| Location | 109 Dundee Ave, Barrington, Illinois |
| Authorized Official Name and Position | Diane L Randall (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8474467636 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane Randall Clinical Services Pc 842 Bristol Dr Barrington IL 60010-4507 Ph: (847) 446-7636 | Diane Randall Clinical Services Pc 109 Dundee Ave Barrington IL 60010-4201 Ph: (847) 446-7636 |
| NPI Number | 1952969412 |
|---|---|
| Provider Enumeration Date | 05/30/2019 |
| Last Update Date | 07/18/2024 |
| Certification Date | 07/18/2024 |
| Medicare PECOS PAC ID | 5799163663 |
|---|---|
| Medicare Enrollment ID | O20220606000479 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952969412 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Diane L Randall |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871647628 PECOS PAC ID: 6002955994 Enrollment ID: I20091207000305 |
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