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NPI Code Detail

MEDICARE: MRS. MICHELLE MARIE FRAUENDORFF

MEDICARE:  MRS. MICHELLE MARIE FRAUENDORFF
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
1235Z00000XSpeech-Language PathologistIL

General Provider Information

NPI Number : 1043346083
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE MARIE FRAUENDORFF
Provider Business Mailing Address
First Line : 1621 HATCH PL
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60516-3726
Country : US
Telephone Number : 630-969-4496
Fax Number :
Provider Business Practice Location Address
First Line : 1621 HATCH PL
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60516-3726
Country : US
Telephone Number : 630-969-4496
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. MICHELLE MARIE FRAUENDORFF ” Practice Location

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