Provider Demographics
NPI:1609172964
Name:ELENA FRANKFURT MD PC
Entity Type:Organization
Organization Name:ELENA FRANKFURT MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKFURT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-247-1555
Mailing Address - Street 1:977 LAKEVIEW PKWY STE 165
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1444
Mailing Address - Country:US
Mailing Address - Phone:847-247-1555
Mailing Address - Fax:847-247-1515
Practice Address - Street 1:977 LAKEVIEW PKWY STE 165
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1444
Practice Address - Country:US
Practice Address - Phone:847-247-1555
Practice Address - Fax:847-247-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-03
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-091674261QM0801X, 261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health