Provider Demographics
NPI:1508613993
Name:FIERENS LEZCANO, FRANCO I
Entity type:Individual
Prefix:DR
First Name:FRANCO
Middle Name:I
Last Name:FIERENS LEZCANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6930 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-3628
Mailing Address - Country:US
Mailing Address - Phone:630-742-1307
Mailing Address - Fax:
Practice Address - Street 1:6930 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-3628
Practice Address - Country:US
Practice Address - Phone:630-742-1307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL320600000X, 374U00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst