MEDICARE: FRANK C LIU OTR

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
1	174400000X	Specialist	056002901	IL

General Provider Information

NPI Number	:	1841416120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANK C LIU OTR

Provider Business Mailing Address
First Line	:	574 W 3RD ST
Second Line	:
City	:	ELMHURST
State	:	IL
Zip	:	60126-2548
Country	:	US
Telephone Number	:	312-208-1556
Fax Number	:

Provider Business Practice Location Address
First Line	:	165 S BLOOMINGDALE RD
Second Line	:
City	:	BLOOMINGDALE
State	:	IL
Zip	:	60108-1434
Country	:	US
Telephone Number	:	630-980-8700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	07/08/2007

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