Healthcare Provider Details

I. General information

NPI: 1427043017
Provider Name (Legal Business Name): MICHAEL W FRANK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 12/16/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 W 95TH ST STE 308
OAK LAWN IL
60453-2660
US

IV. Provider business mailing address

9500 BORMET DR STE 204
MOKENA IL
60448-8399
US

V. Phone/Fax

Practice location:
  • Phone: 708-346-4040
  • Fax: 708-346-3287
Mailing address:
  • Phone: 708-346-4044
  • Fax: 708-346-3287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number036088672
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: