MEDICARE: DR. FRANK A. DONATELLO D.O.

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
1	207Q00000X	Family Medicine Physician	036083282	IL

General Provider Information

NPI Number	:	1801843156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK A. DONATELLO D.O.

Provider Business Mailing Address
First Line	:	6360 W. 159TH STREET
Second Line	:	SUITES D & E
City	:	OAK FOREST
State	:	IL
Zip	:	60452-2725
Country	:	US
Telephone Number	:	708-535-6204
Fax Number	:	708-535-6431

Provider Business Practice Location Address
First Line	:	6360 W. 159TH STREET
Second Line	:	SUITES D & E
City	:	OAK FOREST
State	:	IL
Zip	:	60452-2725
Country	:	US
Telephone Number	:	708-535-6204
Fax Number	:	708-535-6431

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	04/08/2011

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