Provider Demographics
NPI:1790013761
Name:FRANK PUC, INC.
Entity Type:Organization
Organization Name:FRANK PUC, INC.
Other - Org Name:PERSONAL BEST PERFORMANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:PUC
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:630-615-9170
Mailing Address - Street 1:28 N CASS AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1602
Mailing Address - Country:US
Mailing Address - Phone:630-615-9170
Mailing Address - Fax:630-493-0995
Practice Address - Street 1:28 N CASS AVE
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1602
Practice Address - Country:US
Practice Address - Phone:630-615-9170
Practice Address - Fax:630-493-0995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-02
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070008757225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty