Provider Demographics
NPI:1255866364
Name:DEL CID FRATTI, JUAN DANIEL (MD)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:DANIEL
Last Name:DEL CID FRATTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 WEST POLK ST
Mailing Address - Street 2:SUITE 1503
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:312-864-7202
Mailing Address - Fax:312-864-9725
Practice Address - Street 1:1900 WEST POLK ST
Practice Address - Street 2:SUITE 1503
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-864-7202
Practice Address - Fax:312-864-7202
Is Sole Proprietor?:No
Enumeration Date:2017-04-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL125070075390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program