Provider Demographics
NPI:1477597961
Name:FRASCONE, STEPHEN T (DPM)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:T
Last Name:FRASCONE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:9400 S CICERO AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2536
Mailing Address - Country:US
Mailing Address - Phone:708-424-3201
Mailing Address - Fax:708-424-5001
Practice Address - Street 1:32743 23 MILE RD
Practice Address - Street 2:STE 210
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-1985
Practice Address - Country:US
Practice Address - Phone:586-725-3444
Practice Address - Fax:586-725-0984
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2025-05-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MISF106911213ES0103X
MI5901001691213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3238666Medicaid
MI3238666Medicaid
0E06226003Medicare PIN
MI0420490001Medicare NSC
0E06226003Medicare PIN