Provider Demographics
NPI:1710941216
Name:FRANKEL, PHYLIS M (PHD)
Entity Type:Individual
Prefix:DR
First Name:PHYLIS
Middle Name:M
Last Name:FRANKEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 LAKESIDE PL
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-5314
Mailing Address - Country:US
Mailing Address - Phone:847-433-2258
Mailing Address - Fax:847-433-0853
Practice Address - Street 1:95 LAKESIDE PL
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-5314
Practice Address - Country:US
Practice Address - Phone:847-433-2258
Practice Address - Fax:847-433-0853
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical