Provider Demographics
NPI:1487676482
Name:MEDICAL NEUROLOGY ASSOCIATES SC
Entity Type:Organization
Organization Name:MEDICAL NEUROLOGY ASSOCIATES SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HELGE
Authorized Official - Middle Name:G
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-325-8730
Mailing Address - Street 1:20 E OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3543
Mailing Address - Country:US
Mailing Address - Phone:630-325-8730
Mailing Address - Fax:630-325-8746
Practice Address - Street 1:20 E OGDEN AVE
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3543
Practice Address - Country:US
Practice Address - Phone:630-325-8730
Practice Address - Fax:630-325-8746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL5632084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1285658914OtherNPI
IL1615263OtherBLUE CROSS BLUE SHIELD
IL036045749Medicaid
IL132910043OtherRAIL ROAD MEDICARE
1487676482OtherNPI
IL036052646Medicaid
IL791132460OtherRAIL ROAD MEDICARE
1205858347OtherNPI
IL910230Medicare ID - Type UnspecifiedMEDICARE
1285658914OtherNPI
IL646290Medicare PIN