Provider Demographics
NPI:1740624907
Name:LAFRANO, CHUCK FRANK JR (LMT)
Entity type:Individual
Prefix:
First Name:CHUCK
Middle Name:FRANK
Last Name:LAFRANO
Suffix:JR
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1263 ARAPAHOE CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-0919
Mailing Address - Country:US
Mailing Address - Phone:630-699-7199
Mailing Address - Fax:
Practice Address - Street 1:1263 ARAPAHOE CT
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-0919
Practice Address - Country:US
Practice Address - Phone:630-699-7199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.001273225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL227.001273OtherMASSAGE THERAPY LICENCE