Individual
MR. ALEX W FRANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1111 TRINITY LN, SUITE 111, BLOOMINGTON, IL 61704-8111
(309) 663-6461
(309) 663-5711
Mailing address
611 W. PARK ST, FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004844
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085.004844
STATE LICENSE
IL
Enumeration date
10/15/2013
Last updated
10/27/2021
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