Provider Demographics
NPI:1215204649
Name:BELRICHARD, RANDY ALLEN (BS, DC)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:ALLEN
Last Name:BELRICHARD
Suffix:
Gender:M
Credentials:BS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 CARY ALGONQUIN RD
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-2090
Mailing Address - Country:US
Mailing Address - Phone:847-639-0010
Mailing Address - Fax:
Practice Address - Street 1:395 CARY ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:IL
Practice Address - Zip Code:60013-2090
Practice Address - Country:US
Practice Address - Phone:847-639-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012065111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor