Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 209002120 | IL |
NPI | 1003942723 |
---|---|
Provider Name | Miss Sandra Frank |
First Address | Chicago, IL 60647-2319 |
Second Address | Chicago, IL 60647-2319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 02/11/2021 |