Provider Demographics
NPI:1316283575
Name:SCHWENDEMAN, FRANK JOSEPH JR (OD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JOSEPH
Last Name:SCHWENDEMAN
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:FRANCIS
Other - Middle Name:JOSEPH
Other - Last Name:SCHWENDEMAN
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:9877 WILLIAMS DR
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-6035
Mailing Address - Country:US
Mailing Address - Phone:224-345-4333
Mailing Address - Fax:
Practice Address - Street 1:12300 S IL ROUTE 47
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-9634
Practice Address - Country:US
Practice Address - Phone:847-802-3087
Practice Address - Fax:847-669-1099
Is Sole Proprietor?:No
Enumeration Date:2012-12-17
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1465DT152W00000X
IL046.010920152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1465DTOtherLICENSE
U78132OtherUPIN
KY9369001Medicare PIN