Healthcare Provider Details

I. General information

NPI: 1558881615
Provider Name (Legal Business Name): FRANKLIN MAYS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 06/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1627 N MEADE AVE
CHICAGO IL
60639-3915
US

IV. Provider business mailing address

646 S EUCLID AVE
OAK PARK IL
60304-1204
US

V. Phone/Fax

Practice location:
  • Phone: 708-200-3411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2472R0900X
TaxonomyRenal Dialysis Technician
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: