Provider Demographics
NPI:1427039825
Name:EPSTEIN, RANDY J (MD)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:J
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:806 CENTRAL AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-5613
Mailing Address - Country:US
Mailing Address - Phone:847-432-6010
Mailing Address - Fax:847-432-8241
Practice Address - Street 1:806 CENTRAL AVE
Practice Address - Street 2:STE 300
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-5613
Practice Address - Country:US
Practice Address - Phone:847-432-6010
Practice Address - Fax:847-432-8241
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036062546207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01618233OtherBCBS
4028552OtherAETNA
IL04915295OtherBCBS
80346200OtherRISK SHARING PLAN
IL180004841OtherRAILROAD MEDICARE
2188627003OtherCIGNA
IL410009200OtherRAILROAD MEDICARE
IL036062546Medicaid
IL180020161OtherRAILROAD MEDICARE
IL01618235OtherBCBS
IL410009200OtherRAILROAD MEDICARE
IL180020161OtherRAILROAD MEDICARE
IL180004841OtherRAILROAD MEDICARE
C43343Medicare UPIN