Provider Demographics
NPI:1063947851
Name:FRANTZEN, LELA JEAN (MD ED)
Entity type:Individual
Prefix:MRS
First Name:LELA
Middle Name:JEAN
Last Name:FRANTZEN
Suffix:
Gender:F
Credentials:MD ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:949 WELLINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-6904
Mailing Address - Country:US
Mailing Address - Phone:630-334-0498
Mailing Address - Fax:
Practice Address - Street 1:949 WELLINGTON CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-6904
Practice Address - Country:US
Practice Address - Phone:630-334-0498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-28
Last Update Date:2017-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL778514222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist