Provider Demographics
NPI:1568010056
Name:TERMIN, RANDI M (PT, DPT, SCS)
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:M
Last Name:TERMIN
Suffix:
Gender:F
Credentials:PT, DPT, SCS
Other - Prefix:
Other - First Name:RANDI
Other - Middle Name:M
Other - Last Name:MADDOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 OAKMONT LN STE 600C
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5548
Mailing Address - Country:US
Mailing Address - Phone:630-575-6250
Mailing Address - Fax:630-575-7450
Practice Address - Street 1:4802 LAKEVIEW PKWY STE 101
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-4041
Practice Address - Country:US
Practice Address - Phone:469-863-4203
Practice Address - Fax:469-862-9993
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1310423225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist