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General NPI Number Information
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NPI Number | 1811517576
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Entity Type | Individual
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Provider Name | MANJU MARY FRANKLIN NP
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Gender | Female
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Dates
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Enumeration Date | 04/23/2020
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Last Update Date | 04/23/2020
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Provider Practice Location Address
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Address Line | FAMILY BEHAVIOR CENTER 1455 E GOLF ROAD, SUITE 207
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City | DESPLAINES
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State | IL
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Zip | 60714-6071
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Country | US
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Telephone | 847-274-2267
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Fax |
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Provider Business Mailing Address
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Address Line | 9007 N GREENWOOD AVE
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City | NILES
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State | IL
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Zip | 60714-1417
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Country | US
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Telephone | 773-710-6975
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.021150
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License Number State | IL
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