Healthcare Provider Details

I. General information

NPI: 1609172964
Provider Name (Legal Business Name): ELENA FRANKFURT MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2011
Last Update Date: 07/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

977 LAKEVIEW PKWY STE 165
VERNON HILLS IL
60061-1444
US

IV. Provider business mailing address

977 LAKEVIEW PKWY STE 165
VERNON HILLS IL
60061-1444
US

V. Phone/Fax

Practice location:
  • Phone: 847-247-1555
  • Fax: 847-247-1515
Mailing address:
  • Phone: 847-247-1555
  • Fax: 847-247-1515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number036-091674
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number036-091674
License Number StateIL

VIII. Authorized Official

Name: DR. ELENA FRANKFURT
Title or Position: PRESIDENT
Credential: MD
Phone: 847-247-1555