Provider Demographics
NPI:1770507592
Name:MALDONADO, FRANK ANTONIO (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:ANTONIO
Last Name:MALDONADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1601 BUSH CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-4400
Mailing Address - Country:US
Mailing Address - Phone:847-918-1869
Mailing Address - Fax:
Practice Address - Street 1:3001 GREEN BAY RD
Practice Address - Street 2:DEPARTMENT OF MEDICINE (111)
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064-3048
Practice Address - Country:US
Practice Address - Phone:224-610-2001
Practice Address - Fax:224-610-3868
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036079042207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine