Healthcare Provider Details

I. General information

NPI: 1841416120
Provider Name (Legal Business Name): FRANK C LIU OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 S BLOOMINGDALE RD
BLOOMINGDALE IL
60108-1434
US

IV. Provider business mailing address

574 W 3RD ST
ELMHURST IL
60126-2548
US

V. Phone/Fax

Practice location:
  • Phone: 630-980-8700
  • Fax:
Mailing address:
  • Phone: 312-208-1556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number056002901
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: