| Mickala Randby, Pllc | |
|
1310 Prairie Dr Algonquin IL 60102-4251 | |
| (708) 328-8461 | |
| Not Available |
| Full Name | Mickala Randby, Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1310 Prairie Dr, Algonquin, Illinois |
| Authorized Official Name and Position | Mickala Randby (OWNER) |
| Authorized Official Contact | 7083288461 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mickala Randby, Pllc 1310 Prairie Dr Algonquin IL 60102-4251 Ph: (708) 328-8461 | Mickala Randby, Pllc 1310 Prairie Dr Algonquin IL 60102-4251 Ph: (708) 328-8461 |
| NPI Number | 1912766965 |
|---|---|
| Provider Enumeration Date | 03/13/2024 |
| Last Update Date | 03/13/2024 |
| Certification Date | 03/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912766965 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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