Provider Demographics
NPI:1023156015
Name:ROWE, FRANK A JR (PHD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:A
Last Name:ROWE
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-2110
Mailing Address - Country:US
Mailing Address - Phone:847-475-7631
Mailing Address - Fax:773-722-2404
Practice Address - Street 1:544 NORTH CITYFRONT PLAZA DRIVE
Practice Address - Street 2:24TH FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-595-4008
Practice Address - Fax:773-722-6408
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL71002115103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL71002115Medicaid