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MR. RICHARD RANDOLPH
NPI 1477172914
Counselor - Professional in Chicago, IL

Active since April 14, 2020PECOS EnrolledAccepts Medicare Assignment
11740 S WESTERN AVE, CHICAGO, IL 60643(312) 206-9131 Get Directions Write a Review

NPPES record last updated: April 14, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mr. Richard Randolph NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. RICHARD RANDOLPH (NPI 1477172914) is an individual professional provider in Chicago, Illinois, licensed in Illinois (178012996) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1477172914
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. RICHARD RANDOLPH
Location Address11740 S WESTERN AVEChicago, IL 60643-4732
Mailing Address3216 W 163rd StMarkham, IL 60428-5410 · (312) 206-9131
Phone(312) 206-9131
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateApril 14, 2020
NPPES CertifiedApril 14, 2020
✔ NPI 1477172914 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in IL · 178012996
11740 S WESTERN AVE, Chicago, IL 60643
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Richard Randolph is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID143769075
PECOS Enrollment IDI20240823000883
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Richard Randolph reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Solutions Counseling And Consulting Group
2.0 mi
Professional
1649 W 103RD ST
Chicago, IL 60643
  • Reassigned Medicare billing, Illinois enrollment
  • 2 clinicians in this Medicare group
NPI 1083175764 (312) 241-3761

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOLUTIONS COUNSELING AND CONSULTING GROUP
Clinic/Center (Adult Mental Health)
11740 S WESTERN AVE
CHICAGO, IL 60643
Cook County (773) 505-2128
JASMINE KAYLA JOHNSON LPC
Counselor (Professional)
11740 S WESTERN AVE
CHICAGO, IL 60643
Cook County (312) 241-3761
MEISHA YMARI SEARCY LPC
Counselor (Mental Health)
11740 S WESTERN AVE
CHICAGO, IL 60643
Cook County (312) 241-3761
HOPE LEE MA, NCC, LPC
Counselor (Professional)
11740 S WESTERN AVE
CHICAGO, IL 60643
Cook County (872) 240-7076
BEACON THERAPEUTIC SCHOOL, INC.
Community/Behavioral Health
11740 S WESTERN AVE
CHICAGO, IL 60643
Cook County (773) 233-3821
SOLUTIONS COUNSELING AND CONSULTING GROUP
Rehabilitation, Substance Use Disorder Unit
11740 S WESTERN AVE
CHICAGO, IL 60643
Cook County (312) 241-3761
COMMUNITY COUNSELING CENTERS OF CHICAGO
Clinic/Center (Mental Health (Including Community Mental Health Center))
11740 S WESTERN AVE
CHICAGO, IL 60643
Cook County (773) 371-2700
AUDRA MARIE ROWE
Counselor (Professional)
11740 S WESTERN AVE
CHICAGO, IL 60643
Cook County (312) 241-3761

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Richard Randolph's NPI number?

The NPI number for Richard Randolph is 1477172914. It was assigned to this individual provider in the NPPES registry on April 14, 2020.

Where is Richard Randolph located?

Richard Randolph practices at 11740 S Western Ave, Chicago, IL 60643. The listed phone number is (312) 206-9131.

What is Richard Randolph's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Richard Randolph enrolled in Medicare?

Yes. Richard Randolph is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Richard Randolph's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Richard Randolph reassigns Medicare benefits to Solutions Counseling And Consulting Group (Chicago, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Richard Randolph's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Richard Randolph was last updated on April 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.