Provider Demographics
NPI:1457450967
Name:FRANK MINARDI, D.O., S.C.
Entity Type:Organization
Organization Name:FRANK MINARDI, D.O., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:MINARDI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:773-792-2100
Mailing Address - Street 1:7447 W TALCOTT AVE
Mailing Address - Street 2:SUITE 515
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3745
Mailing Address - Country:US
Mailing Address - Phone:773-792-2100
Mailing Address - Fax:773-792-8578
Practice Address - Street 1:7447 W TALCOTT AVE
Practice Address - Street 2:SUITE 515
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3745
Practice Address - Country:US
Practice Address - Phone:773-792-2100
Practice Address - Fax:773-792-8578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036062366Medicaid
IL31601286OtherBLUE CROSS BLUE SHIELD
IL208677Medicare ID - Type Unspecified
0328930001Medicare NSC
ILC46191Medicare UPIN