Healthcare Provider Details

I. General information

NPI: 1346809381
Provider Name (Legal Business Name): FRANK A DISILVIO JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2019
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4309 W MEDICAL CENTER DR STE B202
MCHENRY IL
60050-8417
US

IV. Provider business mailing address

4309 W MEDICAL CENTER DR STE B202
MCHENRY IL
60050-8417
US

V. Phone/Fax

Practice location:
  • Phone: 815-455-2752
  • Fax: 815-455-2789
Mailing address:
  • Phone: 815-455-2752
  • Fax: 815-455-2789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number279846
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036180721
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number036180721
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: