Provider Demographics
NPI:1316956196
Name:FRANKOVICH, MARGARET H
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:H
Last Name:FRANKOVICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 E TIMBER ST # A
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:IL
Mailing Address - Zip Code:61764-2128
Mailing Address - Country:US
Mailing Address - Phone:815-844-2610
Mailing Address - Fax:815-844-2652
Practice Address - Street 1:325 E TIMBER ST # A
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:IL
Practice Address - Zip Code:61764-2128
Practice Address - Country:US
Practice Address - Phone:815-844-2610
Practice Address - Fax:815-844-2652
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK27099Medicare ID - Type Unspecified