Calisoff, Randy Lyle
Calisoff, Randy Lyle is an individual health care provider with primary practice located at 355 E Erie St Fl 14 , Chicago IL 60611-3167. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Calisoff, Randy Lyle can be contacted via phone (312) 238-7800.Contact Information
Primary practice address
355 E Erie St Fl 14
Chicago IL 60611-3167
Phone: (312) 238-7800
Fax: (312) 238-7801
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 036-123018 | Illinois |
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 036-123018 | Illinois |
| Allopathic & Osteopathic Physicians / Pain Medicine | 2081P2900X | 036-123018 | Illinois |
Profile Details
| NPI number | 1205920659 |
|---|---|
| LBN Legal business name | Calisoff, Randy Lyle |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Apr 22nd, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205920659 | NPPES |
| Illinois | MEDICAID | 036123018-1 |
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