Provider Demographics
NPI:1275522377
Name:KAHAN, RANDALL C (MD)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:C
Last Name:KAHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 W RAND RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-2315
Mailing Address - Country:US
Mailing Address - Phone:847-221-4900
Mailing Address - Fax:847-221-4996
Practice Address - Street 1:1051 W RAND RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-2315
Practice Address - Country:US
Practice Address - Phone:847-221-4900
Practice Address - Fax:847-221-4996
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-078109207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036078109OtherSTATE LICENSE
IL748450OtherPROVDER GROUP MEDICARE
ILL66731Medicare PIN