Chang, Randy

Chang, Randy is an individual health care provider with primary practice located at 916 N Green Bay Rd , Waukegan IL 60085-2240. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Chang, Randy can be contacted via phone (847) 336-8200.

Contact Information

Primary practice address
916 N Green Bay Rd Waukegan IL 60085-2240
Phone: (847) 336-8200
Fax: (847) 336-8203
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 48587 California
Dental Providers / General Practice 1223G0001X DS7874 Tennessee
Dental Providers / General Practice 1223G0001X 019-025589 Illinois

Profile Details

NPI number 1013913342
LBN Legal business name Chang, Randy
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated Mar 7th, 2023 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013913342 NPPES
Other 73-1733714 FED TAX ID
Other 019-025589 FED TAX ID
Other DS7874 FED TAX ID
Other 48587 FED TAX ID

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