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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. JAKUB RANDALL PHD
NPI 1568763225
Counselor - Professional in Chicago, IL

Active since November 11, 2010Opted out of Medicare · through Jan 6, 2027
53 W JACKSON BLVD STE 426, CHICAGO, IL 60604(312) 771-3475(312) 771-3475 Get Directions Write a Review

NPPES record last updated: September 12, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 12, 2026, Sep 1, 2026, Oct 4, 2023 and 1 more (4 updates tracked since 2019).

About Dr. Jakub Randall Phd NPPES

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

DR. JAKUB RANDALL PHD (NPI 1568763225) is an individual professional provider in Chicago, Illinois, licensed in Illinois (180007664) and active in the NPI registry since November 2010. He has opted out of Medicare through January 6, 2027.

NPPES Registry Identity

NPI1568763225
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameDR. JAKUB RANDALLCredential: PHD
Location Address53 W JACKSON BLVD STE 426Chicago, IL 60604-3413
Mailing Address3712 N Broadway St, Pbm 145Chicago, IL 60613-4235 · (312) 771-3475 · Fax (312) 771-3475
Phone(312) 771-3475
Fax(312) 771-3475
Sole ProprietorYes
Enumeration DateNovember 11, 2010
Last NPPES UpdateSeptember 12, 20264 updates tracked since enumeration
NPPES CertifiedSeptember 12, 2026
✔ NPI 1568763225 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 · 180007664
53 W JACKSON BLVD STE 426, Chicago, IL 60604
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jakub Randall Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 6, 2025 through January 6, 2027.

Opt-Out Effective DateJanuary 6, 2025
Opt-Out In Effect ThroughJanuary 6, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 2

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

QUINTESS COUNSELING, PLLC
Counselor (Mental Health)
53 W JACKSON BLVD STE 426
CHICAGO, IL 60604
Cook County (312) 771-3475
ERIK SCHUSTER MA
Counselor (Professional)
53 W JACKSON BLVD STE 426
CHICAGO, IL 60604
Cook County (312) 771-3475

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 Jakub Randall's NPI number?

The NPI number for Jakub Randall is 1568763225. It was assigned to this individual provider in the NPPES registry on November 11, 2010.

Where is Jakub Randall located?

Jakub Randall practices at 53 W Jackson Blvd Ste 426, Chicago, IL 60604. The listed phone number is (312) 771-3475.

What is Jakub Randall's specialty?

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

Is Jakub Randall enrolled in Medicare?

No. Jakub Randall has opted out of Medicare through January 6, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jakub Randall was last updated on September 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 25 days 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.