Provider Demographics
NPI:1235281338
Name:MORDINI, FRANK ANTHONY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:ANTHONY
Last Name:MORDINI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15010 S RAVINIA AVE
Mailing Address - Street 2:STE 14
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-5353
Mailing Address - Country:US
Mailing Address - Phone:708-349-4420
Mailing Address - Fax:708-349-4421
Practice Address - Street 1:15010 S RAVINIA AVE
Practice Address - Street 2:STE 14
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-5353
Practice Address - Country:US
Practice Address - Phone:708-349-4420
Practice Address - Fax:708-349-4421
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071004113103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL345471Medicare ID - Type Unspecified