Provider Demographics
NPI:1740341593
Name:BEARDEN, FRANK L (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:L
Last Name:BEARDEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2011 EAST 75TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649
Mailing Address - Country:US
Mailing Address - Phone:773-752-2483
Mailing Address - Fax:773-752-2583
Practice Address - Street 1:2011 EAST 75TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649
Practice Address - Country:US
Practice Address - Phone:773-752-2483
Practice Address - Fax:773-752-2583
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2012-10-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL056072371207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036072371Medicaid