Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 036084396 | IL |
NPI | 1013996701 |
---|---|
Provider Name | Dr. Frank M. Phillips |
First Address | Westchester, IL 60154-5701 |
Second Address | Chicago, IL 60612-3841 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 18/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036084396 2 | (05) | IL |
1633878 | BCBS GROUP ID# (01) | IL |
207067 | MEDICARE PTAN LOCALITY 16 (01) | IL |
207073 | MEDICARE PTAN LOCALITY 15 (01) | IL |
5981079 | AETNA ID# (01) | IL |
DA4902 | RR MEDICARE PTAN# (01) | IL |
G13623 | (02) | IL |
P00066468 | RR MEDICARE ID# (01) | IL |