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General NPI Number Information
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NPI Number | 1487844031
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Entity Type | Individual
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Provider Name | FRANK ANTHONY MECCIA PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/30/2007
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Last Update Date | 07/30/2007
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Provider Practice Location Address
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Address Line | 7435 W TALCOTT AVE
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City | CHICAGO
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State | IL
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Zip | 60631-3707
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Country | US
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Telephone | 773-792-7942
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Fax | 773-792-5151
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Provider Business Mailing Address
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Address Line | 6219 W CORNELIA AVE
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City | CHICAGO
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State | IL
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Zip | 60634-4120
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Country | US
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Telephone | 773-427-5194
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Fax | 773-427-5194
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 85000463
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License Number State | IL
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