Provider Demographics
NPI:1659642221
Name:JEFF AND KRISTY FRANK 1 INC
Entity Type:Organization
Organization Name:JEFF AND KRISTY FRANK 1 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-758-1039
Mailing Address - Street 1:620 W VETERANS PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-4567
Mailing Address - Country:US
Mailing Address - Phone:815-758-1039
Mailing Address - Fax:
Practice Address - Street 1:620 W VETERANS PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-4567
Practice Address - Country:US
Practice Address - Phone:815-758-1039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009566152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty