Elizabeth A Randolph, PA-C is a
Physician Assistant - Medical based in Fairview Heights, Illinois. Elizabeth A Randolph is licensed to practice in Illinois (license number 085.004815) and her current practice location is
5031 N Illinois St, Fairview Heights, Illinois. She can be reached at her office (for appointments etc.) via phone at
(618) 212-6800.
NPI number for Elizabeth A Randolph is 1689000713 and her current mailing address is 5031 N Illinois St, Fairview Heights, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1689000713.
Provider's Profile
Full Name | Elizabeth A Randolph |
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Gender | Female |
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Speciality | Physician Assistant - Medical |
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Location | 5031 N Illinois St, Fairview Heights, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1689000713
- Provider Enumeration Date: 09/20/2013
- Last Update Date: 09/20/2013
Medical Identifiers
Medical identifiers for Elizabeth A Randolph such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1689000713 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363AM0700X | Physician Assistant - Medical | 085.004815 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Elizabeth A Randolph is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Elizabeth A Randolph, PA-C 5031 N Illinois St, Fairview Heights, IL 62208-3453 Ph: (618) 212-6800 | Elizabeth A Randolph, PA-C 5031 N Illinois St, Fairview Heights, IL 62208-3453 Ph: (618) 212-6800 |
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