Healthcare Provider Details

I. General information

NPI: 1376916346
Provider Name (Legal Business Name): FRENZEL HEALTHCARE, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2015
Last Update Date: 11/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 BRYANT AVE
GLEN ELLYN IL
60137-4702
US

IV. Provider business mailing address

462 BRYANT AVE
GLEN ELLYN IL
60137-4702
US

V. Phone/Fax

Practice location:
  • Phone: 630-858-5664
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070005569
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JENNIFER FRENZEL
Title or Position: LEAD THERAPIST
Credential:
Phone: 630-204-2633