RANDALL D GRANT

EVERGREEN PARK, IL
NPI1528370624
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207P00000X Emergency Medicine
(Licence: IL  036142144)
Additional Taxonomies207P00000X Emergency Medicine
(Licence: IN  02007636A)
207P00000X Emergency Medicine
(Licence: OH  34.014212)
Enumeration Date2010-07-06
Last Update Date2025-09-30
Business Address
RANDALL D GRANT D.O.
2800 W 95TH ST
EVERGREEN PARK, IL 60805-2701
Phone number: 518-542-0860
Mailing Address
RANDALL D GRANT D.O.
2800 W 95TH ST
EVERGREEN PARK, IL 60805-2701
Phone number: 518-542-0860