Healthcare Provider Details

I. General information

NPI: 1154567477
Provider Name (Legal Business Name): ANKE FRONZ PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2008
Last Update Date: 12/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7411 W LAKE ST STE 2190
RIVER FOREST IL
60305-1896
US

IV. Provider business mailing address

2819 N MOZART ST # 2
CHICAGO IL
60618-7714
US

V. Phone/Fax

Practice location:
  • Phone: 708-488-1700
  • Fax:
Mailing address:
  • Phone: 773-255-4947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number160.004921
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: