RANDOLPH MCCONNIE (MD) – Pediatric Gastroenterology Physician, NPI 1770580706
Pediatric Gastroenterology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
448 GASTROENTEROLOGY in IN
Provider Addresses for RANDOLPH MCCONNIE (MD)
1201 S Main St
Crown Point, IN 463078481
Phone: (219) 757-6000
Type: Location
1725 W Harrison St
Chicago, IL 606123841
Phone: (312) 942-3034
Type: Location
1645 W Jackson Blvd
Chicago, IL 606123276
Phone: (312) 942-3034
Type: Location
1620 W Harrison St
Chicago, IL 606123801
Phone: (800) 543-7362
Type: Location
1653 W Congress Pkwy
Chicago, IL 606123833
Phone: (312) 942-3034
Type: Location
PO BOX 967
TINLEY PARK, IL 604770967
Phone:
Type: Mailing
17850, Kedzie Avenue, Hazel Crest, Bremen Township, Cook County, Illinois, 60429, United States
3200
HAZEL CREST, IL 604292058
Phone: (708) 798-8112
Fax: (708) 798-9016
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $115.
Total Amount is formed as General ($115) + Research ($0) + Ownership ($0) = $115.
Last reported payment date: 2023-10-10 • Largest payer in this snapshot: Mirum Pharmaceuticals, Inc. ($115).
Total Amount
$115
General + Research + Ownership
Payments
1
Total payment records
General Amount
$115
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-10-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Mirum Pharmaceuticals, Inc. | $115 |
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: 2004-12-09
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 |
|---|---|---|---|---|
| I20041209000992 | I | Gastroenterology | 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 46307)
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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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