Pass, Randall S.

Pass, Randall S. is an individual health care provider with primary practice located at 1506 S. Sioux Dr , Marion IL 62959-0000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Pass, Randall S. can be contacted via phone (618) 997-5270.

Contact Information

Primary practice address
1506 S. Sioux Dr Marion IL 62959-0000
Phone: (618) 997-5270
Fax: (618) 997-5029
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 41607 Wisconsin
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-116809 Illinois

Profile Details

NPI number 1831149228
LBN Legal business name Pass, Randall S.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Jul 7th, 2012 - about 14 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 1831149228 NPPES
Illinois MEDICAID 370966854023
Illinois Other 10007546
Illinois Other 163392
Illinois Other CF3444
Illinois MEDICAID 036116809
Illinois Other 10032052

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