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Contact Information

RANDALL W SUMMERVILLE, PSYD
477 E BUTTERFIELD RD STE 102
LOMBARD, IL60148-4880
 Phone: 630-424-8900
 Fax: 630-424-9017
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Adult Development & Aging

103TA0700X 62 Psychologist, Clinical
 

Clinical Neuropsychologist

103G00000X
Indicates primary specialty

NPI Profile & details for RANDALL W SUMMERVILLE · (Male)

NPI # 1821180803
Status Active
Credentials PSYD (Doctor of Psychology)
Entity Individual
Enumeration date 09/28/2006
Last updated 12/05/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 071-006658
  • IL Other 02233000 BCBS OF IL GROUP PROVIDER
  • IL Other 071-0006658 PROFESSIONAL LICENSE
Hospital affiliation(s)
  • ADVENTIST LA GRANGE MEMORIAL HOSPITAL - (Acute Care)
    5101 S WILLOW SPRINGS RD
    LA GRANGE, IL 60525
  • ADVOCATE GOOD SAMARITAN HOSPITAL - (Acute Care)
    3815 HIGHLAND AVENUE
    DOWNERS GROVE, IL 60515
  • EDWARD HOSPITAL - (Acute Care)
    801 SOUTH WASHINGTON
    NAPERVILLE, IL 60540
  • HINSDALE HOSPITAL - (Acute Care)
    120 NORTH OAK ST
    HINSDALE, IL 60521
  • MACNEAL HOSPITAL - (Acute Care)
    3249 SOUTH OAK PARK AVENUE
    BERWYN, IL 60402
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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