LAURA C. RANDOLPH MD SC NPI 1255527727

NPI Information

  • NPI: 1255527727
  • Provider Name: LAURA C. RANDOLPH MD SC
  • Classification: Clinic/Center - 261QM2500X
  • Specialization: Medical Specialty
  • Entity Type: Organization
  • Address: 2502 E EMPIRE ST
    SUITE C
    BLOOMINGTON, IL
    ZIP 61704
  • Phone: (309) 664-6222

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NPI Details

LAURA C. RANDOLPH MD SC is a medical specialty clinic center in Bloomington, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). LAURA C. RANDOLPH MD SC NPI is 1255527727. The provider is registered as an organization entity type.

The provider's business location address is:

2502 E EMPIRE ST
SUITE C
BLOOMINGTON, IL
ZIP 61704-738
Phone: (309) 664-6222
Fax: (309) 664-5006

The provider's authorized official is Rita Dempsey .
The authorized official title is Office Manager and has the following contact phone number (309) 664-6222.

The enumeration date for this NPI number is 9/19/2007 and was last updated on 9/19/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM2500XClinic/CenterMedical Specialty36100030ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P00193845OTHERILLINOISRAILROAD MEDICARE
25732066OTHERILLINOISBLUE CROSS BLUE SHIELD
3097565OTHERILLINOISHEALTH ALLIANCE
4209832MEDICARE PINILLINOIS
5686867OTHERILLINOISHEALTH LINK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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