Provider Demographics
NPI:1245496140
Name:FRANK, CHANA (PTA)
Entity type:Individual
Prefix:
First Name:CHANA
Middle Name:
Last Name:FRANK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:CHANA
Other - Middle Name:
Other - Last Name:EISENBACH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:6635 N LAWNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-3709
Mailing Address - Country:US
Mailing Address - Phone:847-673-7166
Mailing Address - Fax:847-673-2782
Practice Address - Street 1:7000 N MCCORMICK BLVD
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-2726
Practice Address - Country:US
Practice Address - Phone:847-673-4147
Practice Address - Fax:847-673-2782
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160004096225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant