Provider Demographics
NPI:1811517576
Name:FRANKLIN, MANJU MARY (NP)
Entity type:Individual
Prefix:
First Name:MANJU
Middle Name:MARY
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9007 N GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1417
Mailing Address - Country:US
Mailing Address - Phone:773-710-6975
Mailing Address - Fax:
Practice Address - Street 1:FAMILY BEHAVIOR CENTER
Practice Address - Street 2:1455 E GOLF ROAD, SUITE 207
Practice Address - City:DESPLAINES
Practice Address - State:IL
Practice Address - Zip Code:60714-6071
Practice Address - Country:US
Practice Address - Phone:847-274-2267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.021150363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily