SearchIllinoisBehavior Technician

Michael Randolph

NPI 1922752153 · on the registry since 2022

Practice

Address
917 Sherwood Dr Ste 201
Lake Bluff, IL 60044
Phone
(855) 318-6404
Organisation at this address
Lake Forest Pediatric Associates, Ltd
Inferred from a shared address, not stated in the registry.
Clinicians at this address
116

Registry record

Primary taxonomy
Behavior Technician
106S00000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2022-02-07

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois