Individual
DR. MERIDITH KOVARY-FRANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
25 N WINFIELD RD., WINFIELD, IL 60190-1295
(630) 933-6631
(630) 933-4936
Mailing address
25 N WINFIELD RD., WINFIELD, IL 60190-1295
(630) 933-6631
(630) 933-4936
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008258
IL
103TC2200X
Clinical Child & Adolescent Psychologist
019221
NY
103TC2200X
Clinical Child & Adolescent Psychologist
PSY1000721
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147086
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
10/20/2011
Last updated
12/26/2013
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