Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 071008579 | IL |
Y | 103TC0700X | Clinical Psychologist | 071008579 | IL |
NPI | 1003259227 |
---|---|
Provider Name | Ms. Michelle T Frank |
First Address | Plainfield, IL 60544-5804 |
Second Address | Chicago, IL 60622-9225 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2013 |
Last Update Date | 08/04/2013 |