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General NPI Number Information
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NPI Number | 1356592828
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Entity Type | Organization
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Legal Business Name | FRIENDLY FAMILY MEDICAL CARE, INC.
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Dates
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Enumeration Date | 10/02/2008
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Last Update Date | 02/10/2021
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Provider Practice Location Address
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Address Line | 10225 W LINCOLN HWY
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City | FRANKFORT
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State | IL
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Zip | 60423-1279
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Country | US
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Telephone | 815-464-0081
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Fax | 815-464-0538
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Provider Business Mailing Address
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Address Line | 10225 W LINCOLN HWY
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City | FRANKFORT
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State | IL
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Zip | 60423-1279
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Country | US
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Telephone | 815-464-0081
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Fax | 815-464-0538
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Authorized Official
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Title or Position | OWNER
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Name | DR. TISA ANNE MORRIS-CHRISTIAN
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Credential | M.D.
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Telephone | 815-464-0081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 036101122
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License Number State | IL
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