RANDY DALE MALAN (NPI# 1407853609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407853609 |
| Entity Type | Individual |
| Full Name | RANDY DALE MALAN |
| Credential | R.PH. |
| Practice Address |
401 N 4th St First Floor Springfield IL 62702-5255 |
| Mailing Address |
512 Huntington Glen Carbon IL 62034-1952 |
| Practice Telephone | 2177858983 |
| Mailing Telephone | 6182884520 |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1300X |
Pharmacist Specialization: Psychiatric |
IL | Pharmacy Service Providers |
| Street Address |
401 N 4TH ST FIRST FLOOR |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-5255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841525847 | Brad S Koechle | Pharmacist | 401 N 4th St, Springfield, IL 62702-5205 | 2009-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 1835P1300X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Psychiatric |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing care of patients with psychiatric illness by assessing and monitoring patients, recognizing drug-induced problems, and recommending appropriate treatment plans. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336687888 | Joshua Holland | Pharmacist | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2017-02-04 |
| 1184995573 | Karen M. Coderre | Pharmacist | 1 Monarch Pl, Suite 1500, Springfield, MA 01144-1500 | 2012-01-18 |
| 1841525847 | Brad S Koechle | Pharmacist | 401 N 4th St, Springfield, IL 62702-5205 | 2009-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972950442 | Norman Howard Leeds | Pharmacist | 5 Grenadier Ct, Lincolnshire, IL 60069-3343 | 2016-05-15 |
| 1144600693 | Tatiana Mauda | Pharmacist | 1310 W 18th St Apt 3b, Chicago, IL 60608-3132 | 2015-05-30 |
| 1558640656 | David G. Fuentes Jr. | Pharmacist | 1400 N Roosevelt Blvd, 245, Schaumburg, IL 60173-4377 | 2011-08-08 |
| 1518044098 | Todd Paul Semla | Pharmacist | 2732 Lincolnwood Dr, Evanston, IL 60201-1229 | 2006-11-01 |
| 1881695708 | Jennifer L Zacher | Pharmacist | 852 S West St, Naperville, IL 60540-6400 | 2005-08-02 |
| 1326045675 | Christopher Michael Gillette | Pharmacist | 228 Ne Jefferson Ave, Peoria, IL 61603-3639 | 2005-07-01 |
| 1588280937 | Laine Ferrill | Pharmacist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-06-22 |
| 1568990802 | Amy Butz | Pharmacist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2017-05-31 |
| 1477838886 | Jamie C Holmes | Pharmacist | 3001 Green Bay Rd, North Chicago, IL 60064-3048 | 2011-10-17 |
| 1144330655 | Donna Marie Givone | Pharmacist | 820 S Damen Ave, Pharmacy Service (119), Chicago, IL 60612-3728 | 2006-08-30 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
Please comment or provide details below to improve the information on RANDY DALE MALAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.