Healthcare Provider Details

I. General information

NPI: 1538246566
Provider Name (Legal Business Name): FRANK MARIO NEBBIA RKT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROOSEVELT AND FIFTH AVE.
HINES IL
60141
US

IV. Provider business mailing address

216 N LOMBARD AVE
LOMBARD IL
60148-2011
US

V. Phone/Fax

Practice location:
  • Phone: 708-202-2288
  • Fax: 708-202-2281
Mailing address:
  • Phone: 630-620-7278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code226300000X
TaxonomyKinesiotherapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: