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NPI Code Detail

MEDICARE: REGINA THERESE DEFRANCO

MEDICARE: REGINA THERESE DEFRANCO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner209.015103IL

General Provider Information

NPI Number : 1033651211
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGINA THERESE DEFRANCO
Provider Business Mailing Address
First Line : 5159 S ASHLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60609-4931
Country : US
Telephone Number : 773-434-9216
Fax Number :
Provider Business Practice Location Address
First Line : 5159 S ASHLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60609-4931
Country : US
Telephone Number : 773-434-9216
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2016
Last Update Date : 11/05/2016

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Directions to “ REGINA THERESE DEFRANCO ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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