Individual
FRATMISHIN JOHN ALEXANDER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
6408 N CALIFORNIA AVE, CHICAGO, IL 60645-5209
(773) 338-6565
(773) 338-6552
Mailing address
6408 N CALIFORNIA AVE, PO BOX 597770, CHICAGO, IL 60645-5209
(773) 338-6565
(773) 338-6552
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001041
—
IL
Enumeration date
06/02/2006
Last updated
07/08/2007
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