Provider Demographics
NPI:1184792749
Name:FRANKFURT, ELENA - (MD)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:-
Last Name:FRANKFURT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:977 LAKEVIEW PKWY STE 165
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1444
Mailing Address - Country:US
Mailing Address - Phone:847-247-1555
Mailing Address - Fax:847-245-1515
Practice Address - Street 1:977 LAKEVIEW PKWY STE 165
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1444
Practice Address - Country:US
Practice Address - Phone:847-247-1555
Practice Address - Fax:847-245-1515
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG-16542Medicare UPIN
IL202832Medicare ID - Type Unspecified