Provider Demographics
NPI:1538287297
Name:RANDALL F. SUMMERS, D.D.S.,LTD
Entity Type:Organization
Organization Name:RANDALL F. SUMMERS, D.D.S.,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-759-4400
Mailing Address - Street 1:391 QUADRANGLE DR
Mailing Address - Street 2:SUITE S-5
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-3442
Mailing Address - Country:US
Mailing Address - Phone:630-759-4400
Mailing Address - Fax:630-759-9528
Practice Address - Street 1:391 QUADRANGLE DR
Practice Address - Street 2:SUITE S-5
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-3442
Practice Address - Country:US
Practice Address - Phone:630-759-4400
Practice Address - Fax:630-759-9528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty