Basic Information
| Provider Information | |||||||||
| NPI: | 1174544316 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VAUGHT | ||||||||
| FirstName: | FRANK | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | DC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11933 S PULASKI RD STE C | ||||||||
| Address2: | |||||||||
| City: | ALSIP | ||||||||
| State: | IL | ||||||||
| PostalCode: | 608031100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3147045959 | ||||||||
| FaxNumber: | 7083968605 | ||||||||
| Practice Location | |||||||||
| Address1: | 13657 CICERO AVE | ||||||||
| Address2: | |||||||||
| City: | CRESTWOOD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604451936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7083962500 | ||||||||
| FaxNumber: | 7083968605 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2006 | ||||||||
| LastUpdateDate: | 06/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 038010171 | IL | Y | Chiropractic Providers | Chiropractor |
No ID Information.