Basic Information
Provider Information
NPI: 1508005489
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANK
FirstName: ZACHARY
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: DEPT CH 14389
Address2:  
City: PALATINE
State: IL
PostalCode: 600554389
CountryCode: US
TelephoneNumber: 7852958108
FaxNumber: 7852315991
Practice Location
Address1: 801 SW FAIRLAWN RD
Address2:  
City: TOPEKA
State: KS
PostalCode: 666062338
CountryCode: US
TelephoneNumber: 7852281700
FaxNumber: 7852730716
Other Information
ProviderEnumerationDate: 02/17/2009
LastUpdateDate: 06/10/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208100000X1103620KSY Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 

No ID Information.


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