ELIZABETH K RANDOLPH (PA-C) – Physician Assistant, NPI 1083962229
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for ELIZABETH K RANDOLPH (PA-C)
251 E HURON ST STE 16-738
CHICAGO, IL 606112908
Phone: (847) 234-5600
Fax: (847) 535-7203
Type: Mailing
251 E HURON ST.
CHICAGO, IL 60611
Phone: (312) 926-5140
Type: Location
4814 N CLARK ST
APT 204
CHICAGO, IL 60640
Phone:
Type: Mailing
1000 N WESTMORELAND RD # LEVEL1
LAKE FOREST, IL 600451658
Phone: (312) 695-1800
Fax: (847) 535-7151
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-10-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20141020002295 | I | Physician Assistant | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60611)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | IL | |
| Internal Medicine | IL | |
| Diagnostic Radiology | WI | |
| Internal Medicine | MI | |
| Hematology/Oncology, Hospice/Palliative Care | IL | |
| Nurse Practitioner | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OH | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| O T O L A R Y N G O L O G Y | CT |
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