Provider Demographics
NPI:1467610691
Name:ANTONINO, FRANK GEORGE (DC)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:GEORGE
Last Name:ANTONINO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E CHICAGO AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1746
Mailing Address - Country:US
Mailing Address - Phone:630-920-8203
Mailing Address - Fax:630-920-8237
Practice Address - Street 1:200 E CHICAGO AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1746
Practice Address - Country:US
Practice Address - Phone:630-920-8203
Practice Address - Fax:630-920-8237
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.004840111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology