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NPI Code Detail

MEDICARE: DR. MITCHELL FRANK GRASSESCHI MD

MEDICARE: DR. MITCHELL FRANK GRASSESCHI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208200000XPlastic Surgery Physician036047895IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
221608613OTHERILBLUE SHIELD

General Provider Information

NPI Number : 1801863097
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MITCHELL FRANK GRASSESCHI MD
Provider Business Mailing Address
First Line : PO BOX 8500
Second Line : LOCKBOX 7642
City : PHILADELPHIA
State : PA
Zip : 19178-7642
Country : US
Telephone Number : 813-281-8115
Fax Number : 813-281-8656
Provider Business Practice Location Address
First Line : 2211 N OAK PARK AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60707-3351
Country : US
Telephone Number : 773-622-5400
Fax Number : 773-622-5838
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2006
Last Update Date : 04/10/2017

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